WENDY JOHNSON
Dependent on policy B06M000777
Claims
2
Attributed to this person
Charged
871.00
Total submitted
Denied
370.35
2 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 | WENDY JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000777 |
| Date of birth | 15 Jun 2008 |
| Plan | SILVER HMO |
| Covered from | 2 Dec 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 |
|---|---|---|---|---|---|
| CLM0003428 | 20 Jul 2026 | 769.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 268.35 |
| CLM0003429 | 30 Nov 2024 | 102.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 102.00 |