GRACE JOHNSON
Subscriber on policy B05M000866
Claims
1
Attributed to this person
Charged
193.00
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 JOHNSON |
| Role on the policy | Subscriber |
| Policy | B05M000866 |
| Date of birth | 29 Mar 1961 |
| Plan | BRONZE EPO |
| Covered from | 30 Mar 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 |
|---|---|---|---|---|---|
| CLM0003672 | 11 Mar 2026 | 193.00 | CASCADE CARE | Not denied | — |