DAVID JOHNSON
Subscriber on policy B08M000836
Claims
3
Attributed to this person
Charged
1,378.00
Total submitted
Denied
462.00
1 denied claims
Patient responsibility
40.00
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 | B08M000836 |
| Date of birth | 11 Jun 1964 |
| Plan | PLATINUM PPO |
| Covered from | 4 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003727 | 8 Jul 2026 | 592.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003726 | 1 Sep 2025 | 324.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003728 | 16 Jul 2025 | 462.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 462.00 |