VICTOR VARGAS
Dependent on policy B10M000304
Claims
3
Attributed to this person
Charged
1,657.00
Total submitted
Denied
520.22
2 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 | VICTOR VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000304 |
| Date of birth | 2 May 1957 |
| Plan | GOLD PPO |
| Covered from | 14 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 |
|---|---|---|---|---|---|
| CLM0001276 | 8 Jul 2026 | 320.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 157.70 |
| CLM0001277 | 25 May 2026 | 609.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001278 | 27 Nov 2024 | 728.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 362.52 |