JULIA JOHNSON
Dependent on policy B06M000760
Claims
1
Attributed to this person
Charged
60.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
12.00
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | JULIA JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000760 |
| Date of birth | 13 Aug 1952 |
| Plan | GOLD PPO |
| Covered from | 1 Mar 2025 |
| Covered to | 25 May 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 12.00 |
| Total | 12.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003363 | 24 Mar 2025 | 60.00 | MERIDIAN HEALTH PLAN | Not denied | — |