TOMAS VARGAS
Subscriber on policy B02M000686
Claims
3
Attributed to this person
Charged
1,901.00
Total submitted
Denied
822.00
1 denied claims
Patient responsibility
107.55
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 | TOMAS VARGAS |
| Role on the policy | Subscriber |
| Policy | B02M000686 |
| Date of birth | 8 Sep 1971 |
| Plan | GOLD PPO |
| Covered from | 14 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 107.55 |
| Total | 107.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002897 | 15 Feb 2026 | 822.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 822.00 |
| CLM0002898 | 28 Dec 2025 | 717.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002899 | 14 Mar 2025 | 362.00 | MERIDIAN HEALTH PLAN | Not denied | — |