IVAN VARGAS
Dependent on policy B10M000078
Claims
1
Attributed to this person
Charged
280.00
Total submitted
Denied
280.00
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 | IVAN VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000078 |
| Date of birth | 18 Aug 1985 |
| Plan | PLATINUM PPO |
| Covered from | 18 Aug 2024 |
| Covered to | 4 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000324 | 11 Aug 2024 | 280.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 280.00 |