IVAN GARCIA
Dependent on policy B07M000244
Claims
3
Attributed to this person
Charged
1,569.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
98.25
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 | IVAN GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000244 |
| Date of birth | 25 Oct 1994 |
| Plan | GOLD PPO |
| Covered from | 29 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 98.25 |
| Total | 98.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001043 | 28 Sep 2025 | 558.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001042 | 7 Jun 2025 | 655.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001044 | 1 Jun 2024 | 356.00 | MERIDIAN HEALTH PLAN | Not denied | — |