FIONA VARGAS
Subscriber on policy B02M000348
Claims
1
Attributed to this person
Charged
175.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.00
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 | FIONA VARGAS |
| Role on the policy | Subscriber |
| Policy | B02M000348 |
| Date of birth | 29 Oct 1997 |
| Plan | SILVER HMO |
| Covered from | 2 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001490 | 19 Nov 2025 | 175.00 | NORTHSTAR MUTUAL | Not denied | — |