DAVID JOHNSON
Subscriber on policy B10M000708
Claims
3
Attributed to this person
Charged
728.00
Total submitted
Denied
351.67
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 | DAVID JOHNSON |
| Role on the policy | Subscriber |
| Policy | B10M000708 |
| Date of birth | 5 Mar 2002 |
| Plan | BRONZE EPO |
| Covered from | 11 May 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0002960 | 8 Jun 2026 | 286.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002962 | 31 Mar 2026 | 319.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 319.00 |
| CLM0002961 | 19 Mar 2026 | 123.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 32.67 |