RAVI JOHNSON
Dependent on policy B09M000292
Claims
1
Attributed to this person
Charged
92.00
Total submitted
Denied
92.00
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 | RAVI JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000292 |
| Date of birth | 29 Dec 2006 |
| Plan | SILVER HMO |
| Covered from | 7 Oct 2024 |
| Covered to | 19 Mar 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 |
|---|---|---|---|---|---|
| CLM0001202 | 6 Apr 2025 | 92.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 92.00 |