SOFIA GARCIA
Dependent on policy B10M000458
Claims
2
Attributed to this person
Charged
735.00
Total submitted
Denied
425.00
1 denied claims
Patient responsibility
46.50
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 | Dependent · relationship 01 |
| Policy | B10M000458 |
| Date of birth | 8 Aug 1977 |
| Plan | BRONZE EPO |
| Covered from | 7 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 46.50 |
| Total | 46.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001899 | 7 Jul 2026 | 425.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 425.00 |
| CLM0001898 | 25 Jun 2026 | 310.00 | MERIDIAN HEALTH PLAN | Not denied | — |