HENRY VARGAS
Dependent on policy B04M000526
Claims
2
Attributed to this person
Charged
1,399.00
Total submitted
Denied
785.00
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 | Dependent · relationship 19 |
| Policy | B04M000526 |
| Date of birth | 27 Feb 2014 |
| Plan | PLATINUM PPO |
| Covered from | 25 Apr 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 |
|---|---|---|---|---|---|
| CLM0002276 | 14 Jul 2026 | 785.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 785.00 |
| CLM0002275 | 1 Oct 2025 | 614.00 | NORTHSTAR MUTUAL | Not denied | — |