OMAR JOHNSON
Dependent on policy B05M000894
Claims
3
Attributed to this person
Charged
808.00
Total submitted
Denied
277.00
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 | OMAR JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000894 |
| Date of birth | 22 Apr 1991 |
| Plan | SILVER HMO |
| Covered from | 19 Mar 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 |
|---|---|---|---|---|---|
| CLM0003808 | 11 May 2026 | 277.00 | CASCADE CARE | CARC 18 · DUPLICATE | 277.00 |
| CLM0003807 | 3 Oct 2025 | 432.00 | CASCADE CARE | Not denied | — |
| CLM0003806 | 8 Sep 2025 | 99.00 | CASCADE CARE | Not denied | — |