GRACE JOHNSON
Dependent on policy B08M000025
Claims
3
Attributed to this person
Charged
1,657.00
Total submitted
Denied
579.00
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 JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000025 |
| Date of birth | 2 Jun 1991 |
| Plan | GOLD PPO |
| Covered from | 4 Jun 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 |
|---|---|---|---|---|---|
| CLM0000117 | 19 Apr 2026 | 579.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 579.00 |
| CLM0000116 | 29 Jan 2025 | 344.00 | CASCADE CARE | Not denied | — |
| CLM0000115 | 17 Oct 2024 | 734.00 | CASCADE CARE | Not denied | — |