AMARA GARCIA
Dependent on policy B03M000842
Claims
3
Attributed to this person
Charged
1,180.00
Total submitted
Denied
965.78
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 | AMARA GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000842 |
| Date of birth | 31 Jan 2005 |
| Plan | GOLD PPO |
| Covered from | 11 Mar 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 |
|---|---|---|---|---|---|
| CLM0003638 | 28 Mar 2025 | 255.00 | CASCADE CARE | CARC 18 · DUPLICATE | 113.78 |
| CLM0003639 | 17 Mar 2025 | 73.00 | CASCADE CARE | Not denied | — |
| CLM0003640 | 15 Feb 2024 | 852.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 852.00 |