DAVID GARCIA
Subscriber on policy B09M000506
Claims
2
Attributed to this person
Charged
1,244.00
Total submitted
Denied
884.00
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 | DAVID GARCIA |
| Role on the policy | Subscriber |
| Policy | B09M000506 |
| Date of birth | 4 May 1990 |
| Plan | GOLD PPO |
| Covered from | 4 Mar 2024 |
| Covered to | 15 Nov 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002138 | 4 Jan 2025 | 360.00 | CASCADE CARE | Not denied | — |
| CLM0002137 | 23 Dec 2024 | 884.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 884.00 |