MARCUS VARGAS
Dependent on policy B08M000296
Claims
3
Attributed to this person
Charged
1,527.00
Total submitted
Denied
233.00
1 denied claims
Patient responsibility
194.10
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 | MARCUS VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000296 |
| Date of birth | 28 Dec 1995 |
| Plan | SILVER HMO |
| Covered from | 11 Mar 2024 |
| Covered to | 26 Aug 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 2 | 194.10 |
| Total | 194.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001373 | 3 Sep 2024 | 233.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 233.00 |
| CLM0001375 | 27 Jul 2024 | 782.00 | CASCADE CARE | Not denied | — |
| CLM0001374 | 7 May 2024 | 512.00 | CASCADE CARE | Not denied | — |