HENRY JOHNSON
Dependent on policy B09M000628
Claims
2
Attributed to this person
Charged
810.00
Total submitted
Denied
93.00
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 | Dependent · relationship 19 |
| Policy | B09M000628 |
| Date of birth | 10 Jan 2020 |
| 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 |
|---|---|---|---|---|---|
| CLM0002656 | 19 Dec 2025 | 93.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 93.00 |
| CLM0002655 | 4 May 2025 | 717.00 | MERIDIAN HEALTH PLAN | Not denied | — |