TOMAS VARGAS
Subscriber on policy B03M000609
Claims
2
Attributed to this person
Charged
178.00
Total submitted
Denied
65.00
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 | TOMAS VARGAS |
| Role on the policy | Subscriber |
| Policy | B03M000609 |
| Date of birth | 10 Feb 1977 |
| Plan | SILVER HMO |
| Covered from | 13 Jul 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 |
|---|---|---|---|---|---|
| CLM0002505 | 30 Aug 2024 | 65.00 | CASCADE CARE | CARC 11 · CODING | 65.00 |
| CLM0002506 | 25 Jul 2024 | 113.00 | CASCADE CARE | Not denied | — |