FIONA JOHNSON
Dependent on policy B03M000198
Claims
2
Attributed to this person
Charged
673.00
Total submitted
Denied
104.69
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 | FIONA JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000198 |
| Date of birth | 6 Aug 2012 |
| Plan | GOLD PPO |
| Covered from | 15 Aug 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 |
|---|---|---|---|---|---|
| CLM0000826 | 13 Aug 2025 | 456.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000825 | 15 Jun 2025 | 217.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 104.69 |