JULIA VARGAS
Subscriber on policy B05M000141
Claims
3
Attributed to this person
Charged
1,494.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
544.65
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 | Subscriber |
| Policy | B05M000141 |
| Date of birth | 25 Nov 1966 |
| Plan | SILVER HMO |
| Covered from | 24 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 534.30 |
| CARC 1 · Deductible | 1 | 10.35 |
| Total | 544.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000581 | 20 Aug 2025 | 69.00 | CASCADE CARE | Not denied | — |
| CLM0000582 | 1 Dec 2024 | 822.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0000580 | 17 Aug 2024 | 603.00 | CASCADE CARE | Not denied | — |