GRACE VARGAS
Dependent on policy B06M000029
Claims
3
Attributed to this person
Charged
1,596.00
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 | GRACE VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000029 |
| Date of birth | 11 Dec 2012 |
| Plan | BRONZE EPO |
| Covered from | 6 Dec 2024 |
| Covered to | 11 Jun 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 |
|---|---|---|---|---|---|
| CLM0000174 | 26 Apr 2025 | 747.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000173 | 10 Dec 2024 | 521.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000175 | 6 Dec 2024 | 328.00 | NORTHSTAR MUTUAL | Not denied | — |