WENDY DIAZ
Dependent on policy B07M000007
Claims
2
Attributed to this person
Charged
373.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
45.15
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 | WENDY DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000007 |
| Date of birth | 1 Aug 1990 |
| Plan | PLATINUM PPO |
| Covered from | 24 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 45.15 |
| Total | 45.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000043 | 4 Mar 2026 | 72.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000044 | 23 Oct 2024 | 301.00 | MERIDIAN HEALTH PLAN | Not denied | — |