HENRY GARCIA
Dependent on policy B02M000260
Claims
3
Attributed to this person
Charged
1,334.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
47.10
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 | HENRY GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000260 |
| Date of birth | 28 May 2009 |
| Plan | SILVER HMO |
| Covered from | 8 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 47.10 |
| Total | 47.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001143 | 16 Jul 2026 | 644.00 | CASCADE CARE | Not denied | — |
| CLM0001141 | 21 Sep 2025 | 314.00 | CASCADE CARE | Not denied | — |
| CLM0001142 | 29 Aug 2025 | 376.00 | CASCADE CARE | Not denied | — |