OMAR VARGAS
Subscriber on policy B07M000396
Claims
3
Attributed to this person
Charged
1,625.00
Total submitted
Denied
1,557.00
2 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 | OMAR VARGAS |
| Role on the policy | Subscriber |
| Policy | B07M000396 |
| Date of birth | 26 Sep 1963 |
| Plan | BRONZE EPO |
| Covered from | 8 Mar 2024 |
| Covered to | 2 Aug 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 |
|---|---|---|---|---|---|
| CLM0001677 | 23 Sep 2024 | 763.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 763.00 |
| CLM0001678 | 20 Jun 2024 | 794.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 794.00 |
| CLM0001679 | 19 Apr 2024 | 68.00 | CASCADE CARE | Not denied | — |