IVAN JOHNSON
Subscriber on policy B04M000514
Claims
3
Attributed to this person
Charged
1,391.00
Total submitted
Denied
360.00
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 | B04M000514 |
| Date of birth | 22 Jun 1982 |
| Plan | GOLD PPO |
| Covered from | 10 Jul 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 |
|---|---|---|---|---|---|
| CLM0002216 | 17 Mar 2025 | 432.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002217 | 21 Feb 2025 | 360.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 360.00 |
| CLM0002215 | 22 Dec 2024 | 599.00 | NORTHSTAR MUTUAL | Not denied | — |