KEVIN GARCIA
Subscriber on policy B06M000502
Claims
2
Attributed to this person
Charged
697.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
119.60
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 | KEVIN GARCIA |
| Role on the policy | Subscriber |
| Policy | B06M000502 |
| Date of birth | 4 Nov 1980 |
| Plan | SILVER HMO |
| Covered from | 28 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 119.60 |
| Total | 119.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002244 | 7 Jun 2026 | 184.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0002243 | 14 Dec 2025 | 513.00 | CASCADE CARE | Not denied | — |