OMAR VARGAS
Dependent on policy B04M000528
Claims
3
Attributed to this person
Charged
736.00
Total submitted
Denied
358.00
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 | OMAR VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000528 |
| Date of birth | 11 Jan 2019 |
| Plan | SILVER HMO |
| Covered from | 10 Mar 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 |
|---|---|---|---|---|---|
| CLM0002291 | 27 Nov 2025 | 358.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 358.00 |
| CLM0002293 | 2 Jun 2025 | 293.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002292 | 23 May 2025 | 85.00 | NORTHSTAR MUTUAL | Not denied | — |