AMARA GARCIA
Dependent on policy B05M000540
Claims
1
Attributed to this person
Charged
623.00
Total submitted
Denied
311.40
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 | AMARA GARCIA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000540 |
| Date of birth | 2 Jan 1997 |
| Plan | BRONZE EPO |
| Covered from | 15 Sep 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 |
|---|---|---|---|---|---|
| CLM0002304 | 23 Dec 2025 | 623.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 311.40 |