TOMAS DIAZ
Dependent on policy B07M000160
Claims
2
Attributed to this person
Charged
957.00
Total submitted
Denied
345.00
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 | TOMAS DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000160 |
| Date of birth | 6 Jul 1998 |
| 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 |
|---|---|---|---|---|---|
| CLM0000652 | 29 Nov 2025 | 612.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000651 | 15 Apr 2025 | 345.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 345.00 |