GRACE WILSON
Subscriber on policy B01M000035
Claims
3
Attributed to this person
Charged
1,936.00
Total submitted
Denied
758.00
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 | GRACE WILSON |
| Role on the policy | Subscriber |
| Policy | B01M000035 |
| Date of birth | 29 Aug 1966 |
| Plan | GOLD PPO |
| Covered from | 2 Nov 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 |
|---|---|---|---|---|---|
| CLM0000139 | 11 May 2026 | 395.00 | CASCADE CARE | Not denied | — |
| CLM0000141 | 3 Dec 2025 | 783.00 | CASCADE CARE | Not denied | — |
| CLM0000140 | 25 Oct 2024 | 758.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 758.00 |