TOMAS VARGAS
Subscriber on policy B07M000692
Claims
2
Attributed to this person
Charged
875.00
Total submitted
Denied
528.00
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 VARGAS |
| Role on the policy | Subscriber |
| Policy | B07M000692 |
| Date of birth | 7 Jul 1961 |
| Plan | BRONZE EPO |
| Covered from | 30 Jun 2024 |
| Covered to | 14 Nov 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002864 | 13 Nov 2024 | 528.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 528.00 |
| CLM0002865 | 21 Jul 2024 | 347.00 | MERIDIAN HEALTH PLAN | Not denied | — |