MARCUS DIAZ
Dependent on policy B06M000433
Claims
1
Attributed to this person
Charged
583.00
Total submitted
Denied
583.00
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 | MARCUS DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000433 |
| Date of birth | 4 May 1955 |
| Plan | GOLD PPO |
| Covered from | 9 May 2025 |
| Covered to | 26 Aug 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001995 | 19 Apr 2025 | 583.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 583.00 |