KEVIN VARGAS
Subscriber on policy B05M000313
Claims
2
Attributed to this person
Charged
723.00
Total submitted
Denied
128.00
1 denied claims
Patient responsibility
89.25
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 | KEVIN VARGAS |
| Role on the policy | Subscriber |
| Policy | B05M000313 |
| Date of birth | 15 Feb 1988 |
| Plan | GOLD PPO |
| Covered from | 18 Dec 2024 |
| Covered to | 16 Apr 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 89.25 |
| Total | 89.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001303 | 31 Mar 2025 | 595.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001302 | 24 Nov 2024 | 128.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 128.00 |