CARLA JOHNSON
Subscriber on policy B05M000014
Claims
1
Attributed to this person
Charged
790.00
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 | CARLA JOHNSON |
| Role on the policy | Subscriber |
| Policy | B05M000014 |
| Date of birth | 28 Sep 1960 |
| Plan | BRONZE EPO |
| Covered from | 30 May 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000047 | 12 Jul 2025 | 790.00 | CASCADE CARE | Not denied | — |