GRACE JOHNSON
Dependent on policy B01M000301
Claims
2
Attributed to this person
Charged
721.00
Total submitted
Denied
342.00
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 19 |
| Policy | B01M000301 |
| Date of birth | 30 Dec 1989 |
| Plan | SILVER HMO |
| Covered from | 22 Dec 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 |
|---|---|---|---|---|---|
| CLM0001324 | 2 Aug 2026 | 379.00 | CASCADE CARE | Not denied | — |
| CLM0001325 | 20 Jul 2025 | 342.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 342.00 |