DAVID JOHNSON
Subscriber on policy B07M000064
Claims
2
Attributed to this person
Charged
377.00
Total submitted
Denied
100.00
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 | DAVID JOHNSON |
| Role on the policy | Subscriber |
| Policy | B07M000064 |
| Date of birth | 12 Oct 1987 |
| Plan | BRONZE EPO |
| Covered from | 11 Apr 2025 |
| Covered to | 22 Dec 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000281 | 25 Jul 2025 | 100.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 100.00 |
| CLM0000280 | 17 Jun 2025 | 277.00 | MERIDIAN HEALTH PLAN | Not denied | — |