RAVI DIAZ
Dependent on policy B07M000160
Claims
2
Attributed to this person
Charged
269.00
Total submitted
Denied
269.00
2 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 | RAVI DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000160 |
| Date of birth | 3 Jun 1959 |
| Plan | GOLD PPO |
| Covered from | 24 Mar 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000649 | 9 Nov 2025 | 169.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 169.00 |
| CLM0000650 | 12 Mar 2025 | 100.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 100.00 |