ELENA JOHNSON
Subscriber on policy B09M000036
Claims
1
Attributed to this person
Charged
886.00
Total submitted
Denied
886.00
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 | ELENA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B09M000036 |
| Date of birth | 3 Nov 1993 |
| Plan | GOLD PPO |
| Covered from | 20 Jan 2025 |
| Covered to | open |
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 | 12 Jan 2025 | 886.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 886.00 |