IVAN GARCIA
Dependent on policy B04M000537
Claims
3
Attributed to this person
Charged
824.00
Total submitted
Denied
359.26
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 | IVAN GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000537 |
| Date of birth | 23 Jul 1981 |
| Plan | BRONZE EPO |
| Covered from | 11 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 |
|---|---|---|---|---|---|
| CLM0002345 | 1 Dec 2025 | 221.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002347 | 15 Jul 2025 | 231.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 231.00 |
| CLM0002346 | 7 Apr 2025 | 372.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 128.26 |