GRACE PATEL
Subscriber on policy B03M000678
Claims
2
Attributed to this person
Charged
1,383.00
Total submitted
Denied
593.00
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 PATEL |
| Role on the policy | Subscriber |
| Policy | B03M000678 |
| Date of birth | 3 Sep 1986 |
| Plan | SILVER HMO |
| Covered from | 25 Nov 2024 |
| Covered to | 31 Jul 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002820 | 10 Sep 2025 | 593.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 593.00 |
| CLM0002819 | 3 Feb 2025 | 790.00 | NORTHSTAR MUTUAL | Not denied | — |