UMA GARCIA
Subscriber on policy B09M000712
Claims
1
Attributed to this person
Charged
711.00
Total submitted
Denied
711.00
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 โ 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 | UMA GARCIA |
| Role on the policy | Subscriber |
| Policy | B09M000712 |
| Date of birth | 9 Dec 2000 |
| Plan | SILVER HMO |
| Covered from | 30 Aug 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 |
|---|---|---|---|---|---|
| CLM0003019 | 6 Jul 2025 | 711.00 | NORTHSTAR MUTUAL | CARC 197 ยท AUTHORIZATION | 711.00 |