GRACE ANDERSON
Subscriber on policy B04M000408
Claims
1
Attributed to this person
Charged
340.00
Total submitted
Denied
340.00
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B04M000408 |
| Date of birth | 26 Jan 1988 |
| Plan | BRONZE EPO |
| Covered from | 8 Jan 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 |
|---|---|---|---|---|---|
| CLM0001742 | 7 Nov 2025 | 340.00 | CASCADE CARE | CARC 18 · DUPLICATE | 340.00 |