KEVIN JOHNSON
Dependent on policy B02M000184
Claims
3
Attributed to this person
Charged
1,790.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
125.10
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 | KEVIN JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000184 |
| Date of birth | 28 Nov 1961 |
| Plan | SILVER HMO |
| Covered from | 14 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 125.10 |
| Total | 125.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000817 | 25 Dec 2025 | 235.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000815 | 12 Dec 2025 | 721.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000816 | 9 Aug 2025 | 834.00 | MERIDIAN HEALTH PLAN | Not denied | — |