GRACE JOHNSON
Subscriber on policy B06M000072
Claims
3
Attributed to this person
Charged
1,267.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
72.30
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 | GRACE JOHNSON |
| Role on the policy | Subscriber |
| Policy | B06M000072 |
| Date of birth | 29 May 1971 |
| Plan | GOLD PPO |
| Covered from | 16 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 72.30 |
| Total | 72.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000379 | 5 Aug 2026 | 482.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000381 | 2 Apr 2026 | 449.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000380 | 22 Nov 2025 | 336.00 | MERIDIAN HEALTH PLAN | Not denied | — |