DAVID GARCIA
Dependent on policy B03M000544
Claims
2
Attributed to this person
Charged
1,158.00
Total submitted
Denied
692.00
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 | DAVID GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000544 |
| Date of birth | 8 Nov 1984 |
| 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 |
|---|---|---|---|---|---|
| CLM0002243 | 23 May 2025 | 692.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 692.00 |
| CLM0002242 | 11 May 2025 | 466.00 | MERIDIAN HEALTH PLAN | Not denied | — |