BRIAN GARCIA
Dependent on policy B09M000358
Claims
1
Attributed to this person
Charged
415.00
Total submitted
Denied
153.07
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 | BRIAN GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000358 |
| Date of birth | 2 Aug 2020 |
| Plan | SILVER HMO |
| Covered from | 14 Jan 2025 |
| Covered to | 9 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001481 | 19 Feb 2025 | 415.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 153.07 |