PRIYA VARGAS
Dependent on policy B07M000446
Claims
3
Attributed to this person
Charged
724.00
Total submitted
Denied
119.70
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 | PRIYA VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000446 |
| Date of birth | 2 May 1955 |
| Plan | GOLD PPO |
| Covered from | 28 Mar 2024 |
| Covered to | 4 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 |
|---|---|---|---|---|---|
| CLM0001881 | 4 Sep 2024 | 148.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001880 | 5 Aug 2024 | 350.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 119.70 |
| CLM0001882 | 30 Apr 2024 | 226.00 | NORTHSTAR MUTUAL | Not denied | — |