RAVI GARCIA
Subscriber on policy B06M000233
Claims
2
Attributed to this person
Charged
949.00
Total submitted
Denied
484.00
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 | RAVI GARCIA |
| Role on the policy | Subscriber |
| Policy | B06M000233 |
| Date of birth | 6 Jun 2003 |
| Plan | BRONZE EPO |
| Covered from | 21 Apr 2024 |
| Covered to | 29 Jul 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001107 | 2 Aug 2024 | 484.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 484.00 |
| CLM0001108 | 30 May 2024 | 465.00 | CASCADE CARE | Not denied | — |