VICTOR GARCIA
Subscriber on policy B03M000474
Claims
1
Attributed to this person
Charged
326.00
Total submitted
Denied
326.00
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 | VICTOR GARCIA |
| Role on the policy | Subscriber |
| Policy | B03M000474 |
| Date of birth | 20 Jan 1971 |
| Plan | PLATINUM PPO |
| Covered from | 7 Mar 2025 |
| Covered to | 11 Oct 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 |
|---|---|---|---|---|---|
| CLM0001982 | 9 Nov 2025 | 326.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 326.00 |