HENRY GARCIA
Dependent on policy B05M000063
Claims
2
Attributed to this person
Charged
820.00
Total submitted
Denied
77.00
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 | HENRY GARCIA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000063 |
| Date of birth | 2 Dec 1990 |
| 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 |
|---|---|---|---|---|---|
| CLM0000304 | 25 Sep 2025 | 77.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 77.00 |
| CLM0000303 | 2 Aug 2024 | 743.00 | MERIDIAN HEALTH PLAN | Not denied | — |