YUSUF GARCIA
Subscriber on policy B04M000290
Claims
2
Attributed to this person
Charged
850.00
Total submitted
Denied
39.42
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 | YUSUF GARCIA |
| Role on the policy | Subscriber |
| Policy | B04M000290 |
| Date of birth | 8 Mar 1996 |
| Plan | BRONZE EPO |
| Covered from | 19 Aug 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 |
|---|---|---|---|---|---|
| CLM0001253 | 24 Sep 2025 | 107.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 39.42 |
| CLM0001252 | 13 Aug 2025 | 743.00 | NORTHSTAR MUTUAL | Not denied | — |