WENDY GARCIA
Subscriber on policy B01M000057
Claims
3
Attributed to this person
Charged
1,278.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
10.05
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 | WENDY GARCIA |
| Role on the policy | Subscriber |
| Policy | B01M000057 |
| Date of birth | 1 Jul 1960 |
| Plan | PLATINUM PPO |
| Covered from | 26 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 10.05 |
| Total | 10.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000236 | 25 Feb 2025 | 494.00 | CASCADE CARE | Not denied | — |
| CLM0000237 | 13 Dec 2024 | 717.00 | CASCADE CARE | Not denied | — |
| CLM0000235 | 2 Oct 2024 | 67.00 | CASCADE CARE | Not denied | — |