PRIYA JOHNSON
Subscriber on policy B04M000497
Claims
3
Attributed to this person
Charged
1,095.00
Total submitted
Denied
326.00
1 denied claims
Patient responsibility
40.00
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 | PRIYA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B04M000497 |
| Date of birth | 11 Apr 1997 |
| Plan | BRONZE EPO |
| Covered from | 15 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002136 | 25 Aug 2026 | 421.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002137 | 4 Apr 2026 | 348.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002138 | 21 Oct 2025 | 326.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 326.00 |