BRIAN GARCIA
Subscriber on policy B01M000109
Claims
3
Attributed to this person
Charged
888.00
Total submitted
Denied
364.00
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 | BRIAN GARCIA |
| Role on the policy | Subscriber |
| Policy | B01M000109 |
| Date of birth | 18 Apr 1970 |
| Plan | SILVER HMO |
| Covered from | 25 Jan 2025 |
| Covered to | 29 Aug 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 |
|---|---|---|---|---|---|
| CLM0000433 | 22 Oct 2025 | 228.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 228.00 |
| CLM0000435 | 28 Apr 2025 | 524.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000434 | 27 Feb 2025 | 136.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 136.00 |