NADIA GARCIA
Subscriber on policy B07M000225
Claims
3
Attributed to this person
Charged
2,102.00
Total submitted
Denied
1,610.00
2 denied claims
Patient responsibility
98.40
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 | NADIA GARCIA |
| Role on the policy | Subscriber |
| Policy | B07M000225 |
| Date of birth | 1 Feb 2001 |
| Plan | PLATINUM PPO |
| Covered from | 24 Feb 2025 |
| Covered to | 8 Jun 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 98.40 |
| Total | 98.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000947 | 28 Jan 2025 | 779.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 779.00 |
| CLM0000948 | 28 Jan 2025 | 492.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000946 | 27 Jan 2025 | 831.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 831.00 |