GRACE GARCIA
Subscriber on policy B03M000751
Claims
3
Attributed to this person
Charged
643.00
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 GARCIA |
| Role on the policy | Subscriber |
| Policy | B03M000751 |
| Date of birth | 8 Jun 1997 |
| Plan | GOLD PPO |
| Covered from | 15 Aug 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 |
|---|---|---|---|---|---|
| CLM0003152 | 8 Apr 2026 | 235.00 | CASCADE CARE | Not denied | — |
| CLM0003151 | 4 Oct 2025 | 291.00 | CASCADE CARE | Not denied | — |
| CLM0003150 | 8 Aug 2025 | 117.00 | CASCADE CARE | Not denied | — |