KEVIN VARGAS
Subscriber on policy B07M000029
Claims
3
Attributed to this person
Charged
1,721.00
Total submitted
Denied
267.95
2 denied claims
Patient responsibility
100.40
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 | KEVIN VARGAS |
| Role on the policy | Subscriber |
| Policy | B07M000029 |
| Date of birth | 15 Jun 1981 |
| Plan | BRONZE EPO |
| Covered from | 23 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 100.40 |
| Total | 100.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000129 | 1 May 2026 | 502.00 | CASCADE CARE | Not denied | — |
| CLM0000131 | 8 Mar 2026 | 493.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 19.55 |
| CLM0000130 | 31 Jan 2025 | 726.00 | CASCADE CARE | CARC 109 · COB | 248.40 |