DAVID VARGAS
Subscriber on policy B10M000804
Claims
2
Attributed to this person
Charged
658.00
Total submitted
Denied
658.00
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 | DAVID VARGAS |
| Role on the policy | Subscriber |
| Policy | B10M000804 |
| Date of birth | 29 Dec 1992 |
| Plan | BRONZE EPO |
| Covered from | 11 Oct 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 |
|---|---|---|---|---|---|
| CLM0003395 | 5 Dec 2025 | 209.00 | CASCADE CARE | CARC 18 · DUPLICATE | 209.00 |
| CLM0003396 | 3 Jan 2025 | 449.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 449.00 |