ZARA JOHNSON
Dependent on policy B10M000126
Claims
2
Attributed to this person
Charged
634.00
Total submitted
Denied
81.82
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 | ZARA JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000126 |
| Date of birth | 17 Oct 1963 |
| Plan | PLATINUM PPO |
| Covered from | 7 Jan 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 |
|---|---|---|---|---|---|
| CLM0000535 | 3 Jul 2026 | 281.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 81.82 |
| CLM0000536 | 27 Aug 2024 | 353.00 | NORTHSTAR MUTUAL | Not denied | — |