DenialIntel

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.

ZARA DIAZ

Subscriber on policy B06M000710

Claims
1
Attributed to this person
Charged
608.00
Total submitted
Denied
608.00
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 โ€” 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

FieldValue
NameZARA DIAZ
Role on the policySubscriber
PolicyB06M000710
Date of birth14 Dec 1955
PlanGOLD PPO
Covered from30 Dec 2024
Covered to26 Oct 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000316322 Jul 2025608.00CASCADE CARECARC 11 ยท CODING608.00