BRIAN VARGAS
Dependent on policy B04M000105
Claims
3
Attributed to this person
Charged
1,912.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
350.20
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 | BRIAN VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000105 |
| Date of birth | 12 Jun 1977 |
| Plan | GOLD PPO |
| Covered from | 22 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 2 | 253.60 |
| CARC 1 · Deductible | 1 | 96.60 |
| Total | 350.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000488 | 15 Nov 2025 | 458.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000489 | 24 Sep 2025 | 644.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000487 | 23 Jan 2024 | 810.00 | MERIDIAN HEALTH PLAN | Not denied | — |