IVAN GARCIA
Dependent on policy B03M000544
Claims
1
Attributed to this person
Charged
105.00
Total submitted
Denied
105.00
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 | IVAN GARCIA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000544 |
| Date of birth | 13 Apr 1950 |
| Plan | BRONZE EPO |
| Covered from | 3 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002241 | 23 Apr 2025 | 105.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 105.00 |