WENDY VARGAS
Subscriber on policy B03M000238
Claims
3
Attributed to this person
Charged
2,080.00
Total submitted
Denied
758.00
1 denied claims
Patient responsibility
92.25
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 | WENDY VARGAS |
| Role on the policy | Subscriber |
| Policy | B03M000238 |
| Date of birth | 19 Jan 1968 |
| Plan | SILVER HMO |
| Covered from | 18 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 92.25 |
| Total | 92.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000964 | 9 Jan 2026 | 615.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000963 | 13 Nov 2024 | 707.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000962 | 23 Jan 2024 | 758.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 758.00 |