TOMAS JOHNSON
Subscriber on policy B01M000577
Claims
3
Attributed to this person
Charged
1,612.00
Total submitted
Denied
559.00
1 denied claims
Patient responsibility
0.00
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 | TOMAS JOHNSON |
| Role on the policy | Subscriber |
| Policy | B01M000577 |
| Date of birth | 14 Dec 1978 |
| Plan | BRONZE EPO |
| Covered from | 16 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002572 | 19 Mar 2026 | 559.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 559.00 |
| CLM0002573 | 6 Jan 2026 | 267.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002574 | 19 Oct 2025 | 786.00 | NORTHSTAR MUTUAL | Not denied | — |