IVAN VARGAS
Dependent on policy B06M000310
Claims
3
Attributed to this person
Charged
1,745.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
15.00
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 VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000310 |
| Date of birth | 7 Apr 1966 |
| Plan | BRONZE EPO |
| Covered from | 15 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 15.00 |
| Total | 15.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001421 | 20 Aug 2026 | 470.00 | CASCADE CARE | Not denied | — |
| CLM0001422 | 25 Feb 2024 | 843.00 | CASCADE CARE | Not denied | — |
| CLM0001423 | 24 Jan 2024 | 432.00 | CASCADE CARE | Not denied | — |