AMARA GARCIA
Subscriber on policy B03M000604
Claims
2
Attributed to this person
Charged
1,122.00
Total submitted
Denied
640.00
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 | AMARA GARCIA |
| Role on the policy | Subscriber |
| Policy | B03M000604 |
| Date of birth | 12 Dec 1980 |
| Plan | GOLD PPO |
| Covered from | 17 May 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002483 | 6 Feb 2025 | 482.00 | CASCADE CARE | Not denied | — |
| CLM0002484 | 22 Apr 2024 | 640.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 640.00 |