GRACE VARGAS
Dependent on policy B05M000466
Claims
3
Attributed to this person
Charged
757.00
Total submitted
Denied
66.00
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 | GRACE VARGAS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000466 |
| Date of birth | 5 Oct 2020 |
| Plan | PLATINUM PPO |
| Covered from | 17 May 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001963 | 26 Jul 2026 | 428.00 | CASCADE CARE | Not denied | — |
| CLM0001964 | 30 May 2026 | 66.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 66.00 |
| CLM0001965 | 29 Nov 2025 | 263.00 | CASCADE CARE | Not denied | — |