CARLA JOHNSON
Dependent on policy B07M000293
Claims
3
Attributed to this person
Charged
1,983.00
Total submitted
Denied
0.00
2 denied claims
Patient responsibility
711.75
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 | CARLA JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000293 |
| Date of birth | 30 Jan 1961 |
| Plan | BRONZE EPO |
| Covered from | 9 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 2 | 711.75 |
| Total | 711.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001272 | 28 Nov 2025 | 594.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0001270 | 14 Apr 2025 | 501.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0001271 | 21 Feb 2025 | 888.00 | MERIDIAN HEALTH PLAN | Not denied | — |