RAVI VARGAS
Dependent on policy B01M000235
Claims
3
Attributed to this person
Charged
1,140.00
Total submitted
Denied
406.00
1 denied claims
Patient responsibility
42.15
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 | RAVI VARGAS |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000235 |
| Date of birth | 21 Aug 1977 |
| Plan | GOLD PPO |
| Covered from | 22 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 42.15 |
| Total | 42.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000993 | 18 May 2026 | 453.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000995 | 14 Feb 2026 | 406.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 406.00 |
| CLM0000994 | 1 Jan 2025 | 281.00 | NORTHSTAR MUTUAL | Not denied | — |