ELENA JOHNSON
Subscriber on policy B04M000415
Claims
3
Attributed to this person
Charged
1,427.00
Total submitted
Denied
0.00
0 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 | ELENA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B04M000415 |
| Date of birth | 14 Dec 1973 |
| Plan | PLATINUM PPO |
| Covered from | 26 Jun 2024 |
| Covered to | 21 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001777 | 11 Dec 2024 | 476.00 | CASCADE CARE | Not denied | — |
| CLM0001778 | 28 Nov 2024 | 461.00 | CASCADE CARE | Not denied | — |
| CLM0001776 | 3 Oct 2024 | 490.00 | CASCADE CARE | Not denied | — |