GRACE WILSON
Dependent on policy B09M000338
Claims
3
Attributed to this person
Charged
1,603.00
Total submitted
Denied
998.00
2 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 | Dependent · relationship 01 |
| Policy | B09M000338 |
| Date of birth | 17 Jul 1993 |
| Plan | GOLD PPO |
| Covered from | 12 Mar 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001395 | 28 Feb 2026 | 605.00 | CASCADE CARE | Not denied | — |
| CLM0001393 | 28 Feb 2025 | 470.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 470.00 |
| CLM0001394 | 25 Feb 2025 | 528.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 528.00 |