JULIA VARGAS
Subscriber on policy B03M000293
Claims
1
Attributed to this person
Charged
384.00
Total submitted
Denied
384.00
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 | JULIA VARGAS |
| Role on the policy | Subscriber |
| Policy | B03M000293 |
| Date of birth | 29 Nov 1976 |
| Plan | GOLD PPO |
| Covered from | 9 Feb 2024 |
| Covered to | 28 Apr 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001163 | 18 Jun 2024 | 384.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 384.00 |