AMARA GARCIA
Subscriber on policy B10M000706
Claims
2
Attributed to this person
Charged
857.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
507.65
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 | AMARA GARCIA |
| Role on the policy | Subscriber |
| Policy | B10M000706 |
| Date of birth | 5 Mar 1985 |
| Plan | SILVER HMO |
| Covered from | 28 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 507.65 |
| Total | 507.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002957 | 30 May 2025 | 781.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0002958 | 3 Apr 2025 | 76.00 | CASCADE CARE | Not denied | — |