HENRY GARCIA
Dependent on policy B06M000138
Claims
2
Attributed to this person
Charged
620.00
Total submitted
Denied
347.00
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 | HENRY GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000138 |
| Date of birth | 21 Aug 1996 |
| Plan | SILVER HMO |
| Covered from | 26 May 2025 |
| Covered to | 22 Sep 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 |
|---|---|---|---|---|---|
| CLM0000680 | 11 Oct 2025 | 347.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 347.00 |
| CLM0000679 | 6 Aug 2025 | 273.00 | NORTHSTAR MUTUAL | Not denied | — |