OMAR VARGAS
Subscriber on policy B05M000142
Claims
1
Attributed to this person
Charged
244.00
Total submitted
Denied
244.00
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 | Subscriber |
| Policy | B05M000142 |
| Date of birth | 9 May 1994 |
| Plan | PLATINUM PPO |
| Covered from | 24 Mar 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 |
|---|---|---|---|---|---|
| CLM0000583 | 28 Apr 2024 | 244.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 244.00 |