X12 Ingest & Denial Analytics

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Members›policy B06M000381›TOMAS GARCIA

TOMAS GARCIA

Dependent on policy B06M000381

Claims
1
Attributed to this person
Charged
121.00
Total submitted
Denied
0.00
0 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

FieldValue
NameTOMAS GARCIA
Role on the policyDependent · relationship 19
PolicyB06M000381
Date of birth21 Oct 1987
PlanSILVER HMO
Covered from25 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00017346 Dec 2024121.00MERIDIAN HEALTH PLANNot denied—