UMA JOHNSON
Subscriber on policy B08M000040
Claims
1
Attributed to this person
Charged
562.00
Total submitted
Denied
562.00
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 | UMA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B08M000040 |
| Date of birth | 12 May 1994 |
| Plan | PLATINUM PPO |
| Covered from | 30 Apr 2024 |
| Covered to | 15 Dec 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000171 | 17 Jun 2024 | 562.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 562.00 |