UMA JOHNSON
Subscriber on policy B10M000136
Claims
3
Attributed to this person
Charged
1,783.00
Total submitted
Denied
1,165.00
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 | UMA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B10M000136 |
| Date of birth | 2 Feb 1983 |
| Plan | BRONZE EPO |
| Covered from | 27 Aug 2024 |
| Covered to | 11 Feb 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 |
|---|---|---|---|---|---|
| CLM0000567 | 27 Dec 2024 | 363.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 363.00 |
| CLM0000566 | 30 Nov 2024 | 802.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 802.00 |
| CLM0000565 | 14 Nov 2024 | 618.00 | MERIDIAN HEALTH PLAN | Not denied | — |