WENDY GARCIA
Subscriber on policy B04M000104
Claims
3
Attributed to this person
Charged
549.00
Total submitted
Denied
126.87
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 | WENDY GARCIA |
| Role on the policy | Subscriber |
| Policy | B04M000104 |
| Date of birth | 27 Dec 1989 |
| Plan | SILVER HMO |
| Covered from | 18 Jul 2024 |
| Covered to | 8 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000483 | 12 Nov 2024 | 114.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000482 | 24 Aug 2024 | 365.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 126.87 |
| CLM0000484 | 12 Aug 2024 | 70.00 | MERIDIAN HEALTH PLAN | Not denied | — |