CARLA VARGAS
Subscriber on policy B01M000712
Claims
1
Attributed to this person
Charged
835.00
Total submitted
Denied
835.00
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 | Subscriber |
| Policy | B01M000712 |
| Date of birth | 24 Dec 1999 |
| Plan | PLATINUM PPO |
| Covered from | 5 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003178 | 24 Dec 2024 | 835.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 835.00 |