MARCUS JOHNSON
Subscriber on policy B04M000297
Claims
3
Attributed to this person
Charged
1,274.00
Total submitted
Denied
662.00
2 denied claims
Patient responsibility
269.10
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 | MARCUS JOHNSON |
| Role on the policy | Subscriber |
| Policy | B04M000297 |
| Date of birth | 11 Jun 1964 |
| Plan | PLATINUM PPO |
| Covered from | 27 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 269.10 |
| Total | 269.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001284 | 15 Jul 2026 | 198.00 | CASCADE CARE | Not denied | — |
| CLM0001283 | 30 Dec 2025 | 662.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 662.00 |
| CLM0001282 | 17 Mar 2025 | 414.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |