LEILA GARCIA
Subscriber on policy B01M000775
Claims
1
Attributed to this person
Charged
557.00
Total submitted
Denied
265.55
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 | LEILA GARCIA |
| Role on the policy | Subscriber |
| Policy | B01M000775 |
| Date of birth | 23 Mar 1999 |
| Plan | BRONZE EPO |
| Covered from | 14 Jun 2025 |
| Covered to | 10 Dec 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003445 | 5 Nov 2025 | 557.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 265.55 |