FIONA VARGAS
Subscriber on policy B10M000590
Claims
3
Attributed to this person
Charged
1,102.00
Total submitted
Denied
584.00
2 denied claims
Patient responsibility
249.60
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 | B10M000590 |
| Date of birth | 9 Sep 1963 |
| Plan | BRONZE EPO |
| Covered from | 14 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 249.60 |
| Total | 249.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002439 | 9 Jan 2026 | 584.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 584.00 |
| CLM0002438 | 23 Nov 2025 | 384.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 0.00 |
| CLM0002440 | 13 Nov 2025 | 134.00 | NORTHSTAR MUTUAL | Not denied | — |