KEVIN GARCIA
Dependent on policy B07M000001
Claims
1
Attributed to this person
Charged
730.00
Total submitted
Denied
730.00
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 | KEVIN GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000001 |
| Date of birth | 17 Jan 1982 |
| Plan | GOLD PPO |
| Covered from | 3 Feb 2024 |
| Covered to | 1 Nov 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 |
|---|---|---|---|---|---|
| CLM0000011 | 25 Jun 2024 | 730.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 730.00 |