GRACE CHEN
Subscriber on policy B03M000462
Claims
3
Attributed to this person
Charged
1,278.00
Total submitted
Denied
0.00
0 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 CHEN |
| Role on the policy | Subscriber |
| Policy | B03M000462 |
| Date of birth | 19 Oct 1992 |
| Plan | GOLD PPO |
| Covered from | 16 Feb 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 |
|---|---|---|---|---|---|
| CLM0001912 | 24 Dec 2024 | 311.00 | CASCADE CARE | Not denied | — |
| CLM0001913 | 10 Oct 2024 | 451.00 | CASCADE CARE | Not denied | — |
| CLM0001914 | 3 Jul 2024 | 516.00 | CASCADE CARE | Not denied | — |