GRACE GARCIA
Subscriber on policy B06M000897
Claims
3
Attributed to this person
Charged
795.00
Total submitted
Denied
439.05
2 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 | B06M000897 |
| Date of birth | 21 Jan 1960 |
| Plan | PLATINUM PPO |
| Covered from | 22 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 |
|---|---|---|---|---|---|
| CLM0003915 | 23 Jun 2026 | 351.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 351.00 |
| CLM0003913 | 16 Dec 2025 | 72.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003914 | 8 Dec 2024 | 372.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 88.05 |