AMARA VARGAS
Dependent on policy B08M000497
Claims
1
Attributed to this person
Charged
84.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
12.60
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 | AMARA VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000497 |
| Date of birth | 29 Aug 2008 |
| Plan | PLATINUM PPO |
| Covered from | 19 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 12.60 |
| Total | 12.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002299 | 17 Jan 2024 | 84.00 | CASCADE CARE | Not denied | — |