SOFIA GARCIA
Subscriber on policy B09M000437
Claims
2
Attributed to this person
Charged
864.00
Total submitted
Denied
864.00
2 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 | SOFIA GARCIA |
| Role on the policy | Subscriber |
| Policy | B09M000437 |
| Date of birth | 16 Sep 1950 |
| Plan | SILVER HMO |
| Covered from | 20 Nov 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 |
|---|---|---|---|---|---|
| CLM0001829 | 28 Mar 2025 | 110.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 110.00 |
| CLM0001828 | 5 Mar 2025 | 754.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 754.00 |