RAVI JOHNSON
Dependent on policy B01M000766
Claims
1
Attributed to this person
Charged
877.00
Total submitted
Denied
877.00
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 | RAVI JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000766 |
| Date of birth | 14 Aug 1977 |
| Plan | SILVER HMO |
| Covered from | 21 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003412 | 15 Mar 2026 | 877.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 877.00 |