IVAN JOHNSON
Dependent on policy B09M000628
Claims
3
Attributed to this person
Charged
675.00
Total submitted
Denied
354.00
2 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 | IVAN JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000628 |
| Date of birth | 13 Dec 1998 |
| Plan | PLATINUM PPO |
| Covered from | 18 Jan 2025 |
| Covered to | 5 Nov 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 |
|---|---|---|---|---|---|
| CLM0002653 | 26 Nov 2025 | 240.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 240.00 |
| CLM0002652 | 10 Jul 2025 | 114.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 114.00 |
| CLM0002654 | 23 Apr 2025 | 321.00 | MERIDIAN HEALTH PLAN | Not denied | — |