DAVID JOHNSON
Dependent on policy B03M000795
Claims
3
Attributed to this person
Charged
1,033.00
Total submitted
Denied
465.00
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 | DAVID JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000795 |
| Date of birth | 21 Feb 1968 |
| Plan | PLATINUM PPO |
| Covered from | 15 Nov 2024 |
| Covered to | 13 Aug 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 |
|---|---|---|---|---|---|
| CLM0003396 | 17 May 2025 | 568.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003394 | 7 Apr 2025 | 235.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 235.00 |
| CLM0003395 | 9 Feb 2025 | 230.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 230.00 |