LEILA GARCIA
Subscriber on policy B07M000613
Claims
2
Attributed to this person
Charged
875.00
Total submitted
Denied
777.00
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 | LEILA GARCIA |
| Role on the policy | Subscriber |
| Policy | B07M000613 |
| Date of birth | 13 Mar 1969 |
| Plan | GOLD PPO |
| Covered from | 24 Oct 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 |
|---|---|---|---|---|---|
| CLM0002574 | 25 Feb 2025 | 98.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002575 | 5 Oct 2024 | 777.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 777.00 |