CARLA DIAZ
Subscriber on policy B06M000081
Claims
2
Attributed to this person
Charged
746.00
Total submitted
Denied
162.07
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 | CARLA DIAZ |
| Role on the policy | Subscriber |
| Policy | B06M000081 |
| Date of birth | 6 Nov 1950 |
| Plan | PLATINUM PPO |
| Covered from | 24 Nov 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 |
|---|---|---|---|---|---|
| CLM0000423 | 20 Nov 2025 | 604.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 162.07 |
| CLM0000424 | 8 May 2025 | 142.00 | CASCADE CARE | Not denied | — |