WENDY GARCIA
Subscriber on policy B09M000098
Claims
3
Attributed to this person
Charged
1,787.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
30.00
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 | WENDY GARCIA |
| Role on the policy | Subscriber |
| Policy | B09M000098 |
| Date of birth | 21 Feb 1980 |
| Plan | BRONZE EPO |
| Covered from | 13 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000405 | 30 Nov 2025 | 370.00 | CASCADE CARE | Not denied | — |
| CLM0000404 | 12 Nov 2025 | 813.00 | CASCADE CARE | Not denied | — |
| CLM0000403 | 23 Mar 2025 | 604.00 | CASCADE CARE | Not denied | — |