DAVID JOHNSON
Subscriber on policy B09M000272
Claims
2
Attributed to this person
Charged
1,343.00
Total submitted
Denied
626.00
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 | DAVID JOHNSON |
| Role on the policy | Subscriber |
| Policy | B09M000272 |
| Date of birth | 4 May 1972 |
| Plan | GOLD PPO |
| Covered from | 6 Apr 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0001124 | 1 Nov 2025 | 626.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 626.00 |
| CLM0001123 | 27 Dec 2024 | 717.00 | NORTHSTAR MUTUAL | Not denied | — |