CARLA JOHNSON
Subscriber on policy B09M000020
Claims
3
Attributed to this person
Charged
1,150.00
Total submitted
Denied
695.00
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 | CARLA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B09M000020 |
| Date of birth | 25 Nov 1968 |
| Plan | PLATINUM PPO |
| Covered from | 24 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 |
|---|---|---|---|---|---|
| CLM0000081 | 10 Jan 2026 | 546.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 546.00 |
| CLM0000080 | 3 Jan 2025 | 149.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 149.00 |
| CLM0000079 | 18 Nov 2024 | 455.00 | CASCADE CARE | Not denied | — |