CARLA VARGAS
Dependent on policy B02M000196
Claims
2
Attributed to this person
Charged
415.00
Total submitted
Denied
278.00
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 | CARLA VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000196 |
| Date of birth | 30 Apr 1965 |
| Plan | GOLD PPO |
| Covered from | 14 Mar 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 |
|---|---|---|---|---|---|
| CLM0000861 | 29 Dec 2025 | 137.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000862 | 27 Apr 2025 | 278.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 278.00 |