CARLA DIAZ
Dependent on policy B07M000160
Claims
2
Attributed to this person
Charged
362.00
Total submitted
Denied
230.00
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 | CARLA DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000160 |
| Date of birth | 25 Sep 1986 |
| 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 |
|---|---|---|---|---|---|
| CLM0000657 | 15 Jul 2026 | 132.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000656 | 17 Apr 2026 | 230.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 230.00 |