KEVIN JOHNSON
Dependent on policy B06M000709
Claims
3
Attributed to this person
Charged
1,466.00
Total submitted
Denied
678.00
1 denied claims
Patient responsibility
60.60
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 | KEVIN JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000709 |
| Date of birth | 16 Oct 1980 |
| Plan | BRONZE EPO |
| Covered from | 17 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 60.60 |
| Total | 60.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003158 | 16 Aug 2024 | 404.00 | CASCADE CARE | Not denied | — |
| CLM0003160 | 14 Aug 2024 | 678.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 678.00 |
| CLM0003159 | 9 Aug 2024 | 384.00 | CASCADE CARE | Not denied | — |