JULIA GARCIA
Dependent on policy B07M000654
Claims
2
Attributed to this person
Charged
1,270.00
Total submitted
Denied
699.00
1 denied claims
Patient responsibility
20.00
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 | JULIA GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000654 |
| Date of birth | 18 Sep 2010 |
| Plan | GOLD PPO |
| Covered from | 21 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002729 | 31 Mar 2026 | 571.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002728 | 8 Feb 2024 | 699.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 699.00 |