DAVID JOHNSON
Dependent on policy B10M000708
Claims
3
Attributed to this person
Charged
1,113.00
Total submitted
Denied
668.00
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 | DAVID JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000708 |
| Date of birth | 27 Apr 2005 |
| 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 |
|---|---|---|---|---|---|
| CLM0002964 | 7 Aug 2026 | 369.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002963 | 1 Apr 2026 | 76.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002965 | 25 Jan 2026 | 668.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 668.00 |