TOMAS GARCIA
Dependent on policy B10M000677
Claims
3
Attributed to this person
Charged
955.00
Total submitted
Denied
460.00
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 | TOMAS GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000677 |
| Date of birth | 30 Nov 2009 |
| Plan | SILVER HMO |
| Covered from | 15 Sep 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 |
|---|---|---|---|---|---|
| CLM0002816 | 8 May 2026 | 430.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002817 | 7 Dec 2025 | 65.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002818 | 15 Feb 2025 | 460.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 460.00 |