FIONA VARGAS
Subscriber on policy B10M000391
Claims
1
Attributed to this person
Charged
876.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
569.40
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 | FIONA VARGAS |
| Role on the policy | Subscriber |
| Policy | B10M000391 |
| Date of birth | 14 Dec 1959 |
| Plan | BRONZE EPO |
| Covered from | 5 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 569.40 |
| Total | 569.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001623 | 22 Jun 2026 | 876.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |