VICTOR JOHNSON
Subscriber on policy B08M000065
Claims
2
Attributed to this person
Charged
730.00
Total submitted
Denied
221.00
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 | VICTOR JOHNSON |
| Role on the policy | Subscriber |
| Policy | B08M000065 |
| Date of birth | 24 Aug 1997 |
| Plan | BRONZE EPO |
| Covered from | 19 Oct 2024 |
| Covered to | 5 Feb 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000291 | 23 Jan 2025 | 509.00 | CASCADE CARE | Not denied | — |
| CLM0000292 | 4 Oct 2024 | 221.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 221.00 |