DAVID JOHNSON
Subscriber on policy B06M000498
Claims
3
Attributed to this person
Charged
915.00
Total submitted
Denied
81.18
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 | DAVID JOHNSON |
| Role on the policy | Subscriber |
| Policy | B06M000498 |
| Date of birth | 23 Jul 1996 |
| Plan | BRONZE EPO |
| Covered from | 8 Sep 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002229 | 22 Jan 2026 | 395.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 81.18 |
| CLM0002228 | 17 Sep 2025 | 245.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002227 | 23 Jul 2025 | 275.00 | NORTHSTAR MUTUAL | Not denied | — |