SOFIA VARGAS
Subscriber on policy B09M000795
Claims
3
Attributed to this person
Charged
1,376.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
199.55
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 | Subscriber |
| Policy | B09M000795 |
| Date of birth | 17 Feb 1956 |
| Plan | SILVER HMO |
| Covered from | 2 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 199.55 |
| Total | 199.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003364 | 2 Dec 2025 | 317.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003365 | 15 May 2025 | 752.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003363 | 13 Feb 2025 | 307.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |