RAVI GARCIA
Dependent on policy B01M000775
Claims
2
Attributed to this person
Charged
1,389.00
Total submitted
Denied
714.02
2 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 | RAVI GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000775 |
| Date of birth | 9 Oct 2022 |
| 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 |
|---|---|---|---|---|---|
| CLM0003449 | 12 Nov 2025 | 688.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 13.02 |
| CLM0003450 | 20 Sep 2025 | 701.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 701.00 |