IVAN VARGAS
Dependent on policy B04M000567
Claims
2
Attributed to this person
Charged
927.00
Total submitted
Denied
471.00
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 | IVAN VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000567 |
| Date of birth | 23 Feb 2015 |
| Plan | SILVER HMO |
| Covered from | 5 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 |
|---|---|---|---|---|---|
| CLM0002485 | 18 Oct 2025 | 456.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002484 | 12 Feb 2025 | 471.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 471.00 |