ELENA JOHNSON
Subscriber on policy B02M000635
Claims
2
Attributed to this person
Charged
954.00
Total submitted
Denied
0.00
0 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 | ELENA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B02M000635 |
| Date of birth | 2 Jun 1954 |
| Plan | SILVER HMO |
| Covered from | 23 Jan 2025 |
| Covered to | 2 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002672 | 9 Mar 2025 | 543.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002673 | 22 Feb 2025 | 411.00 | NORTHSTAR MUTUAL | Not denied | — |