VICTOR JOHNSON
Dependent on policy B06M000299
Claims
2
Attributed to this person
Charged
1,245.00
Total submitted
Denied
768.00
2 denied claims
Patient responsibility
310.05
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 | VICTOR JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000299 |
| Date of birth | 5 Sep 2019 |
| Plan | BRONZE EPO |
| Covered from | 8 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 310.05 |
| Total | 310.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001379 | 17 Dec 2025 | 477.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0001380 | 15 Jun 2025 | 768.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 768.00 |