GRACE ANDERSON
Dependent on policy B08M000881
Claims
2
Attributed to this person
Charged
1,089.00
Total submitted
Denied
295.99
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 ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000881 |
| Date of birth | 12 Oct 1976 |
| Plan | GOLD PPO |
| Covered from | 2 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 |
|---|---|---|---|---|---|
| CLM0003940 | 29 Jun 2026 | 214.00 | CASCADE CARE | Not denied | — |
| CLM0003941 | 8 Nov 2025 | 875.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 295.99 |