OMAR GARCIA
Subscriber on policy B08M000359
Claims
2
Attributed to this person
Charged
269.00
Total submitted
Denied
193.00
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 | OMAR GARCIA |
| Role on the policy | Subscriber |
| Policy | B08M000359 |
| Date of birth | 14 Sep 1985 |
| Plan | PLATINUM PPO |
| Covered from | 18 Apr 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 |
|---|---|---|---|---|---|
| CLM0001646 | 28 Apr 2026 | 76.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001645 | 5 Oct 2025 | 193.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 193.00 |