CARLA JOHNSON
Subscriber on policy B02M000615
Claims
3
Attributed to this person
Charged
1,290.00
Total submitted
Denied
870.00
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 | CARLA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B02M000615 |
| Date of birth | 23 May 1989 |
| Plan | PLATINUM PPO |
| Covered from | 19 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0002583 | 16 Apr 2026 | 577.00 | CASCADE CARE | CARC 18 · DUPLICATE | 577.00 |
| CLM0002585 | 16 Jul 2025 | 293.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 293.00 |
| CLM0002584 | 5 May 2025 | 420.00 | CASCADE CARE | Not denied | — |