ELENA JOHNSON
Dependent on policy B05M000076
Claims
1
Attributed to this person
Charged
265.00
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 | Dependent · relationship 01 |
| Policy | B05M000076 |
| Date of birth | 2 Aug 1989 |
| Plan | PLATINUM PPO |
| Covered from | 5 Apr 2025 |
| Covered to | 14 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 |
|---|---|---|---|---|---|
| CLM0000353 | 26 Sep 2025 | 265.00 | CASCADE CARE | Not denied | — |