Dr. Linda Johnson MD
 
 
 Dr. Linda Johnson MD DOB: 2000-03-26 (64 yo M) Acc No. CR285252 
 [Doc Name: SAVANI 2017-04-09 BCBS] 
 Transaction ID: 25049916063 Transaction Date: 2018-07-01 10:26 am Customer ID: 2890716 
 Dr. Linda Johnson MD Subscriber 
 MEMBER ID BZZ10289071601 
 Other Blue Plans 
 DOB 2000-03-26 
 GENDER Male 
 PLAN / COVERAGE DATE 2023-03-26 - 2021-05-27 
 DATE OF SERVICE 2023-02-09 
 Either the patient's ID, name, date of birth, or address in the response does not match the information sent in the request. The 
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 Subscriber Information 
 221 James L Taylor Rd 
 PLAN NUMBER Facets 
 PRIOR ID NUMBER BZZ103459047 
 Plan / Product Information 
 ACTIVE COVERAGE 
 INDIVIDUAL 
 INSURANCE TYPE Preferred Provider Organization (PPO) 
 PLAN / PRODUCT 
 Blue Options 
 Members 18 and over with A1c between 5.7 and 6.1 without Type 2 Diabetes diagnosis are eligible for Virta Diabetes Prevention. 
 Members 18 and older with Type 2 Diabetes are eligible for Virta Diabetes Reversal 
 Service Types 
 Health Benefit Plan Coverage 
 ACTIVE COVERAGE 
 Infertility 
 ACTIVE COVERAGE 
 Preventive Drugs 
 Service Types 
 Pharmacy 
 ACTIVE COVERAGE 
 INDIVIDUAL 
 ACTIVE COVERAGE 
 Smoking Cessation 180 Day Supply Limit 
 ACTIVE COVERAGE 
 Service Types 
 Pharmacy 
 Dr. Linda Johnson MD DOB: 2000-03-26 (64 yo M) Acc No. CR285252 
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