ZARA JOHNSON
Subscriber on policy B07M000392
Claims
3
Attributed to this person
Charged
1,690.00
Total submitted
Denied
456.75
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 | ZARA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B07M000392 |
| Date of birth | 19 Mar 1971 |
| Plan | SILVER HMO |
| Covered from | 18 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 |
|---|---|---|---|---|---|
| CLM0001665 | 27 May 2026 | 645.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 205.98 |
| CLM0001663 | 1 Dec 2025 | 532.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 250.77 |
| CLM0001664 | 20 Apr 2025 | 513.00 | NORTHSTAR MUTUAL | Not denied | — |