ELENA VARGAS
Dependent on policy B04M000105
Claims
3
Attributed to this person
Charged
1,251.00
Total submitted
Denied
883.00
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 | ELENA VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000105 |
| Date of birth | 19 Nov 2012 |
| Plan | GOLD PPO |
| Covered from | 22 Jan 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 |
|---|---|---|---|---|---|
| CLM0000492 | 27 Sep 2025 | 222.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000490 | 8 Feb 2024 | 883.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 883.00 |
| CLM0000491 | 24 Jan 2024 | 146.00 | MERIDIAN HEALTH PLAN | Not denied | — |