OMAR JOHNSON
Subscriber on policy B01M000748
Claims
3
Attributed to this person
Charged
1,326.00
Total submitted
Denied
106.19
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 | OMAR JOHNSON |
| Role on the policy | Subscriber |
| Policy | B01M000748 |
| Date of birth | 2 Feb 1989 |
| Plan | GOLD PPO |
| Covered from | 4 Mar 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 |
|---|---|---|---|---|---|
| CLM0003324 | 23 Nov 2025 | 414.00 | CASCADE CARE | CARC 11 · CODING | 106.19 |
| CLM0003323 | 27 Jul 2025 | 607.00 | CASCADE CARE | Not denied | — |
| CLM0003322 | 11 May 2024 | 305.00 | CASCADE CARE | Not denied | — |