LEILA VARGAS
Subscriber on policy B05M000710
Claims
1
Attributed to this person
Charged
307.00
Total submitted
Denied
77.50
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 | LEILA VARGAS |
| Role on the policy | Subscriber |
| Policy | B05M000710 |
| Date of birth | 19 Jul 2004 |
| Plan | PLATINUM PPO |
| Covered from | 9 Jun 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 |
|---|---|---|---|---|---|
| CLM0003043 | 26 Jun 2026 | 307.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 77.50 |