AMARA GARCIA
Dependent on policy B01M000216
Claims
3
Attributed to this person
Charged
1,357.00
Total submitted
Denied
289.00
1 denied claims
Patient responsibility
82.20
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 | AMARA GARCIA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000216 |
| Date of birth | 30 Dec 1969 |
| Plan | PLATINUM PPO |
| Covered from | 28 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 82.20 |
| Total | 82.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000919 | 16 Jul 2026 | 657.00 | CASCADE CARE | Not denied | — |
| CLM0000921 | 19 Mar 2026 | 289.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 289.00 |
| CLM0000920 | 26 Oct 2024 | 411.00 | CASCADE CARE | Not denied | — |