BRIAN VARGAS
Dependent on policy B07M000336
Claims
2
Attributed to this person
Charged
1,158.00
Total submitted
Denied
849.00
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 | BRIAN VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000336 |
| Date of birth | 28 Sep 1983 |
| Plan | BRONZE EPO |
| Covered from | 14 Jul 2024 |
| Covered to | 27 Dec 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 |
|---|---|---|---|---|---|
| CLM0001437 | 21 Nov 2024 | 849.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 849.00 |
| CLM0001436 | 20 Nov 2024 | 309.00 | NORTHSTAR MUTUAL | Not denied | — |