LEILA JOHNSON
Dependent on policy B02M000070
Claims
3
Attributed to this person
Charged
1,732.00
Total submitted
Denied
840.00
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 | LEILA JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000070 |
| Date of birth | 5 Dec 2010 |
| Plan | PLATINUM PPO |
| Covered from | 7 Jun 2024 |
| Covered to | 25 Dec 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000327 | 30 Nov 2024 | 892.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000326 | 29 May 2024 | 270.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 270.00 |
| CLM0000328 | 25 May 2024 | 570.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 570.00 |