PRIYA JOHNSON
Dependent on policy B04M000167
Claims
3
Attributed to this person
Charged
1,687.00
Total submitted
Denied
267.88
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 | PRIYA JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000167 |
| Date of birth | 19 Aug 2015 |
| 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 |
|---|---|---|---|---|---|
| CLM0000769 | 16 Oct 2025 | 564.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 267.88 |
| CLM0000770 | 11 Aug 2025 | 567.00 | CASCADE CARE | Not denied | — |
| CLM0000768 | 14 Nov 2024 | 556.00 | CASCADE CARE | Not denied | — |