LEILA JOHNSON
Subscriber on policy B08M000245
Claims
3
Attributed to this person
Charged
1,464.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
70.60
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 | LEILA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B08M000245 |
| Date of birth | 18 Mar 2003 |
| Plan | BRONZE EPO |
| Covered from | 8 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 70.60 |
| Total | 70.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001108 | 21 Aug 2026 | 872.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001110 | 25 Apr 2026 | 353.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001109 | 14 Jan 2026 | 239.00 | NORTHSTAR MUTUAL | Not denied | — |