ELENA VARGAS
Subscriber on policy B09M000563
Claims
1
Attributed to this person
Charged
584.00
Total submitted
Denied
584.00
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 | ELENA VARGAS |
| Role on the policy | Subscriber |
| Policy | B09M000563 |
| Date of birth | 20 Jul 1956 |
| Plan | SILVER HMO |
| Covered from | 22 Oct 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 |
|---|---|---|---|---|---|
| CLM0002377 | 20 Feb 2025 | 584.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 584.00 |