IVAN JOHNSON
Subscriber on policy B04M000711
Claims
1
Attributed to this person
Charged
231.00
Total submitted
Denied
231.00
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 | IVAN JOHNSON |
| Role on the policy | Subscriber |
| Policy | B04M000711 |
| Date of birth | 29 Jul 1990 |
| Plan | GOLD PPO |
| Covered from | 16 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003090 | 8 Apr 2025 | 231.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 231.00 |