DAVID DIAZ
Subscriber on policy B06M000513
Claims
3
Attributed to this person
Charged
1,019.00
Total submitted
Denied
239.02
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 | DAVID DIAZ |
| Role on the policy | Subscriber |
| Policy | B06M000513 |
| Date of birth | 3 Oct 1969 |
| Plan | BRONZE EPO |
| Covered from | 24 Mar 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 |
|---|---|---|---|---|---|
| CLM0002285 | 19 Jul 2026 | 484.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 239.02 |
| CLM0002286 | 9 Aug 2025 | 369.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002284 | 2 Jul 2025 | 166.00 | NORTHSTAR MUTUAL | Not denied | — |