VICTOR JOHNSON
Dependent on policy B10M000230
Claims
3
Attributed to this person
Charged
1,236.00
Total submitted
Denied
113.00
1 denied claims
Patient responsibility
101.40
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 | VICTOR JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000230 |
| Date of birth | 24 Feb 1992 |
| Plan | BRONZE EPO |
| Covered from | 2 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 101.40 |
| Total | 101.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000949 | 16 Jun 2026 | 447.00 | CASCADE CARE | Not denied | — |
| CLM0000950 | 2 Feb 2026 | 676.00 | CASCADE CARE | Not denied | — |
| CLM0000951 | 27 Dec 2025 | 113.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 113.00 |