BRIAN JOHNSON
Subscriber on policy B04M000167
Claims
3
Attributed to this person
Charged
785.00
Total submitted
Denied
112.00
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 | BRIAN JOHNSON |
| Role on the policy | Subscriber |
| Policy | B04M000167 |
| Date of birth | 21 Sep 1986 |
| Plan | BRONZE EPO |
| Covered from | 14 Sep 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 |
|---|---|---|---|---|---|
| CLM0000760 | 9 Jun 2025 | 112.00 | CASCADE CARE | CARC 18 · DUPLICATE | 112.00 |
| CLM0000762 | 30 Mar 2025 | 467.00 | CASCADE CARE | Not denied | — |
| CLM0000761 | 10 Dec 2024 | 206.00 | CASCADE CARE | Not denied | — |