GRACE PATEL
Subscriber on policy B04M000647
Claims
3
Attributed to this person
Charged
813.00
Total submitted
Denied
112.00
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 | B04M000647 |
| Date of birth | 18 Nov 1954 |
| Plan | GOLD PPO |
| Covered from | 26 Jul 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 |
|---|---|---|---|---|---|
| CLM0002816 | 17 Feb 2026 | 112.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 112.00 |
| CLM0002817 | 12 Jan 2026 | 402.00 | CASCADE CARE | Not denied | — |
| CLM0002815 | 18 May 2025 | 299.00 | CASCADE CARE | Not denied | — |