IVAN GARCIA
Dependent on policy B05M000842
Claims
2
Attributed to this person
Charged
673.00
Total submitted
Denied
0.00
0 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 01 |
| Policy | B05M000842 |
| Date of birth | 15 Feb 1955 |
| Plan | PLATINUM PPO |
| Covered from | 6 Jan 2025 |
| Covered to | 8 Sep 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 |
|---|---|---|---|---|---|
| CLM0003565 | 6 Jul 2025 | 311.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003566 | 8 Apr 2025 | 362.00 | NORTHSTAR MUTUAL | Not denied | — |