HENRY JOHNSON
Subscriber on policy B01M000319
Claims
2
Attributed to this person
Charged
1,590.00
Total submitted
Denied
728.00
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 | HENRY JOHNSON |
| Role on the policy | Subscriber |
| Policy | B01M000319 |
| Date of birth | 20 Dec 1969 |
| Plan | GOLD PPO |
| Covered from | 13 Oct 2024 |
| Covered to | 21 Mar 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 |
|---|---|---|---|---|---|
| CLM0001416 | 24 Feb 2025 | 728.00 | CASCADE CARE | CARC 11 · CODING | 728.00 |
| CLM0001415 | 25 Oct 2024 | 862.00 | CASCADE CARE | Not denied | — |