FIONA JOHNSON
Dependent on policy B05M000320
Claims
2
Attributed to this person
Charged
573.00
Total submitted
Denied
149.00
1 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 | FIONA JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000320 |
| Date of birth | 29 Nov 2003 |
| Plan | SILVER HMO |
| Covered from | 15 Mar 2024 |
| Covered to | 31 May 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001342 | 9 Jul 2024 | 149.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 149.00 |
| CLM0001343 | 14 Apr 2024 | 424.00 | CASCADE CARE | Not denied | — |