IVAN GARCIA
Dependent on policy B06M000259
Claims
1
Attributed to this person
Charged
283.00
Total submitted
Denied
132.06
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 | IVAN GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000259 |
| Date of birth | 17 May 2020 |
| Plan | BRONZE EPO |
| Covered from | 20 Oct 2024 |
| Covered to | 24 Jan 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001227 | 20 Dec 2024 | 283.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 132.06 |