LEILA GARCIA
Subscriber on policy B07M000412
Claims
2
Attributed to this person
Charged
549.00
Total submitted
Denied
549.00
2 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 | LEILA GARCIA |
| Role on the policy | Subscriber |
| Policy | B07M000412 |
| Date of birth | 13 Mar 1984 |
| Plan | BRONZE EPO |
| Covered from | 30 Dec 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 |
|---|---|---|---|---|---|
| CLM0001740 | 19 Aug 2025 | 458.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 458.00 |
| CLM0001739 | 24 Jan 2025 | 91.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 91.00 |