LEILA VARGAS
Subscriber on policy B01M000104
Claims
2
Attributed to this person
Charged
824.00
Total submitted
Denied
586.80
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 | LEILA VARGAS |
| Role on the policy | Subscriber |
| Policy | B01M000104 |
| Date of birth | 7 Dec 1981 |
| Plan | GOLD PPO |
| Covered from | 5 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000418 | 28 Mar 2026 | 446.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 446.00 |
| CLM0000419 | 19 Oct 2024 | 378.00 | CASCADE CARE | CARC 11 · CODING | 140.80 |