CARLA JOHNSON
Dependent on policy B01M000689
Claims
3
Attributed to this person
Charged
1,512.00
Total submitted
Denied
1,167.00
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 | Dependent · relationship 01 |
| Policy | B01M000689 |
| Date of birth | 18 Feb 1962 |
| Plan | PLATINUM PPO |
| Covered from | 16 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 |
|---|---|---|---|---|---|
| CLM0003088 | 2 Nov 2024 | 326.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 326.00 |
| CLM0003089 | 23 Aug 2024 | 841.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 841.00 |
| CLM0003087 | 3 Apr 2024 | 345.00 | MERIDIAN HEALTH PLAN | Not denied | — |