TOMAS GARCIA
Subscriber on policy B07M000832
Claims
3
Attributed to this person
Charged
965.00
Total submitted
Denied
673.00
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 | TOMAS GARCIA |
| Role on the policy | Subscriber |
| Policy | B07M000832 |
| Date of birth | 22 May 1972 |
| Plan | BRONZE EPO |
| Covered from | 6 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003418 | 9 Jan 2025 | 104.00 | CASCADE CARE | Not denied | — |
| CLM0003419 | 20 Sep 2024 | 673.00 | CASCADE CARE | CARC 18 · DUPLICATE | 673.00 |
| CLM0003417 | 24 Apr 2024 | 188.00 | CASCADE CARE | Not denied | — |