SOFIA GARCIA
Subscriber on policy B05M000063
Claims
1
Attributed to this person
Charged
734.00
Total submitted
Denied
734.00
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 | SOFIA GARCIA |
| Role on the policy | Subscriber |
| Policy | B05M000063 |
| Date of birth | 9 May 1999 |
| Plan | PLATINUM PPO |
| Covered from | 2 Aug 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 |
|---|---|---|---|---|---|
| CLM0000302 | 11 Aug 2025 | 734.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 734.00 |