ZARA JOHNSON
Subscriber on policy B03M000793
Claims
3
Attributed to this person
Charged
1,553.00
Total submitted
Denied
1,553.00
3 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 | ZARA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B03M000793 |
| Date of birth | 9 Jan 2004 |
| Plan | BRONZE EPO |
| Covered from | 24 Aug 2024 |
| Covered to | 19 Jan 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 |
|---|---|---|---|---|---|
| CLM0003379 | 18 Mar 2025 | 684.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 684.00 |
| CLM0003378 | 4 Mar 2025 | 804.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 804.00 |
| CLM0003377 | 5 Feb 2025 | 65.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 65.00 |