ELENA VARGAS
Dependent on policy B10M000894
Claims
2
Attributed to this person
Charged
973.00
Total submitted
Denied
153.14
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 | ELENA VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000894 |
| Date of birth | 7 Jan 2000 |
| Plan | PLATINUM PPO |
| Covered from | 19 May 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 |
|---|---|---|---|---|---|
| CLM0003802 | 13 Dec 2025 | 485.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 153.14 |
| CLM0003803 | 12 Sep 2025 | 488.00 | CASCADE CARE | Not denied | — |