LEILA GARCIA
Subscriber on policy B05M000161
Claims
1
Attributed to this person
Charged
672.00
Total submitted
Denied
249.17
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 | LEILA GARCIA |
| Role on the policy | Subscriber |
| Policy | B05M000161 |
| Date of birth | 23 Apr 1954 |
| Plan | SILVER HMO |
| Covered from | 4 Apr 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 |
|---|---|---|---|---|---|
| CLM0000676 | 28 Mar 2025 | 672.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 249.17 |