X12 Ingest & Denial Analytics

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Members›policy B05M000458›MARCUS GARCIA

MARCUS GARCIA

Dependent on policy B05M000458

Claims
3
Attributed to this person
Charged
428.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
31.95
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

FieldValue
NameMARCUS GARCIA
Role on the policyDependent · relationship 19
PolicyB05M000458
Date of birth28 Jun 2011
PlanSILVER HMO
Covered from27 May 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 1 · Deductible131.95
Total31.95

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000192529 Jun 202679.00MERIDIAN HEALTH PLANNot denied—
CLM00019269 Feb 2026136.00MERIDIAN HEALTH PLANNot denied—
CLM000192426 Jan 2025213.00MERIDIAN HEALTH PLANNot denied—