RAVI JOHNSON
Dependent on policy B02M000130
Claims
1
Attributed to this person
Charged
508.00
Total submitted
Denied
508.00
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 | RAVI JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000130 |
| Date of birth | 22 Mar 2016 |
| Plan | BRONZE EPO |
| Covered from | 7 Feb 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 |
|---|---|---|---|---|---|
| CLM0000600 | 23 Sep 2024 | 508.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 508.00 |