OMAR VARGAS
Subscriber on policy B09M000520
Claims
2
Attributed to this person
Charged
403.00
Total submitted
Denied
147.00
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 | OMAR VARGAS |
| Role on the policy | Subscriber |
| Policy | B09M000520 |
| Date of birth | 12 Apr 1985 |
| Plan | GOLD PPO |
| Covered from | 30 Jul 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 |
|---|---|---|---|---|---|
| CLM0002207 | 9 Jan 2026 | 147.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 147.00 |
| CLM0002206 | 10 Jun 2025 | 256.00 | NORTHSTAR MUTUAL | Not denied | — |