UMA JOHNSON
Dependent on policy B05M000494
Claims
3
Attributed to this person
Charged
851.00
Total submitted
Denied
690.00
2 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 | UMA JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000494 |
| Date of birth | 30 Jun 1948 |
| Plan | PLATINUM PPO |
| Covered from | 27 Mar 2025 |
| Covered to | 22 Nov 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 |
|---|---|---|---|---|---|
| CLM0002115 | 8 Jan 2026 | 72.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 72.00 |
| CLM0002116 | 9 Aug 2025 | 161.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002117 | 4 Mar 2025 | 618.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 618.00 |