TOMAS GARCIA
Subscriber on policy B05M000685
Claims
2
Attributed to this person
Charged
697.00
Total submitted
Denied
112.00
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 | TOMAS GARCIA |
| Role on the policy | Subscriber |
| Policy | B05M000685 |
| Date of birth | 26 Jan 1956 |
| Plan | BRONZE EPO |
| Covered from | 14 Nov 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 |
|---|---|---|---|---|---|
| CLM0002945 | 6 Aug 2025 | 112.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 112.00 |
| CLM0002944 | 7 Feb 2025 | 585.00 | NORTHSTAR MUTUAL | Not denied | — |