SOFIA VARGAS
Dependent on policy B07M000396
Claims
2
Attributed to this person
Charged
1,057.00
Total submitted
Denied
231.65
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 | SOFIA VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000396 |
| Date of birth | 29 Aug 2001 |
| 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 |
|---|---|---|---|---|---|
| CLM0001685 | 8 Jun 2024 | 625.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 231.65 |
| CLM0001686 | 2 Jun 2024 | 432.00 | CASCADE CARE | Not denied | — |