SOFIA GARCIA
Dependent on policy B03M000262
Claims
2
Attributed to this person
Charged
1,088.00
Total submitted
Denied
723.00
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 | SOFIA GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000262 |
| Date of birth | 21 Mar 2015 |
| Plan | SILVER HMO |
| Covered from | 18 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 |
|---|---|---|---|---|---|
| CLM0001060 | 21 Jul 2026 | 723.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 723.00 |
| CLM0001061 | 24 Dec 2025 | 365.00 | NORTHSTAR MUTUAL | Not denied | — |