BRIAN JOHNSON
Dependent on policy B02M000111
Claims
3
Attributed to this person
Charged
1,652.00
Total submitted
Denied
1,064.00
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 | BRIAN JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000111 |
| Date of birth | 6 May 2009 |
| Plan | SILVER HMO |
| Covered from | 5 May 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0000501 | 22 Oct 2025 | 339.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 339.00 |
| CLM0000502 | 7 Oct 2024 | 725.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 725.00 |
| CLM0000500 | 12 Jul 2024 | 588.00 | NORTHSTAR MUTUAL | Not denied | — |