AMARA GARCIA
Subscriber on policy B03M000264
Claims
1
Attributed to this person
Charged
550.00
Total submitted
Denied
0.00
0 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 | AMARA GARCIA |
| Role on the policy | Subscriber |
| Policy | B03M000264 |
| Date of birth | 2 Feb 1953 |
| Plan | GOLD PPO |
| Covered from | 27 Apr 2025 |
| Covered to | 16 Feb 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001064 | 23 May 2025 | 550.00 | NORTHSTAR MUTUAL | Not denied | — |