YUSUF DIAZ
Dependent on policy B06M000685
Claims
2
Attributed to this person
Charged
1,076.00
Total submitted
Denied
620.00
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 | YUSUF DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000685 |
| Date of birth | 12 May 1960 |
| Plan | BRONZE EPO |
| Covered from | 15 May 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 |
|---|---|---|---|---|---|
| CLM0003053 | 15 Feb 2026 | 456.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003054 | 8 Jul 2024 | 620.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 620.00 |