GRACE JOHNSON
Subscriber on policy B07M000011
Claims
3
Attributed to this person
Charged
1,007.00
Total submitted
Denied
75.87
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 | GRACE JOHNSON |
| Role on the policy | Subscriber |
| Policy | B07M000011 |
| Date of birth | 22 Jul 1957 |
| Plan | BRONZE EPO |
| Covered from | 11 May 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0000064 | 8 Oct 2025 | 638.00 | CASCADE CARE | Not denied | — |
| CLM0000063 | 4 May 2025 | 109.00 | CASCADE CARE | Not denied | — |
| CLM0000062 | 27 Jul 2024 | 260.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 75.87 |