HENRY GARCIA
Subscriber on policy B03M000333
Claims
3
Attributed to this person
Charged
1,641.00
Total submitted
Denied
1,083.46
2 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 | HENRY GARCIA |
| Role on the policy | Subscriber |
| Policy | B03M000333 |
| Date of birth | 7 Oct 2002 |
| Plan | SILVER HMO |
| Covered from | 10 Dec 2024 |
| Covered to | 31 May 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001333 | 10 Jul 2025 | 889.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 889.00 |
| CLM0001335 | 11 Mar 2025 | 335.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001334 | 30 Jan 2025 | 417.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 194.46 |