RAVI VARGAS
Dependent on policy B03M000438
Claims
3
Attributed to this person
Charged
1,304.00
Total submitted
Denied
586.00
2 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 | RAVI VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000438 |
| Date of birth | 1 Nov 2000 |
| Plan | BRONZE EPO |
| Covered from | 20 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 |
|---|---|---|---|---|---|
| CLM0001798 | 21 Aug 2025 | 388.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 388.00 |
| CLM0001796 | 24 Jan 2025 | 718.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001797 | 31 Dec 2024 | 198.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 198.00 |