KEVIN DIAZ
Subscriber on policy B01M000565
Claims
2
Attributed to this person
Charged
726.00
Total submitted
Denied
726.00
2 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 | KEVIN DIAZ |
| Role on the policy | Subscriber |
| Policy | B01M000565 |
| Date of birth | 24 May 1953 |
| Plan | GOLD PPO |
| Covered from | 10 Aug 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002513 | 24 Oct 2025 | 258.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 258.00 |
| CLM0002512 | 5 Feb 2025 | 468.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 468.00 |