JULIA VARGAS
Dependent on policy B04M000476
Claims
1
Attributed to this person
Charged
580.00
Total submitted
Denied
580.00
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 | JULIA VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000476 |
| Date of birth | 26 Sep 1994 |
| Plan | GOLD PPO |
| Covered from | 11 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 |
|---|---|---|---|---|---|
| CLM0002035 | 28 Dec 2023 | 580.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 580.00 |