CARLA GARCIA
Subscriber on policy B05M000266
Claims
2
Attributed to this person
Charged
1,257.00
Total submitted
Denied
460.00
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 | CARLA GARCIA |
| Role on the policy | Subscriber |
| Policy | B05M000266 |
| Date of birth | 16 May 1996 |
| Plan | GOLD PPO |
| Covered from | 7 May 2024 |
| Covered to | 12 Dec 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 |
|---|---|---|---|---|---|
| CLM0001103 | 11 Nov 2024 | 797.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001104 | 8 Apr 2024 | 460.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 460.00 |