PRIYA GARCIA
Dependent on policy B02M000857
Claims
3
Attributed to this person
Charged
2,526.00
Total submitted
Denied
867.00
1 denied claims
Patient responsibility
121.80
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 | PRIYA GARCIA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000857 |
| Date of birth | 14 Aug 2001 |
| Plan | BRONZE EPO |
| Covered from | 9 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 121.80 |
| Total | 121.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003574 | 23 Jun 2025 | 812.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003572 | 22 Jul 2024 | 847.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003573 | 5 Apr 2024 | 867.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 867.00 |