HENRY VARGAS
Subscriber on policy B04M000643
Claims
1
Attributed to this person
Charged
508.00
Total submitted
Denied
508.00
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 | HENRY VARGAS |
| Role on the policy | Subscriber |
| Policy | B04M000643 |
| Date of birth | 3 Jul 1963 |
| Plan | BRONZE EPO |
| Covered from | 15 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 |
|---|---|---|---|---|---|
| CLM0002792 | 27 Jun 2025 | 508.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 508.00 |