LEILA DIAZ
Dependent on policy B07M000434
Claims
2
Attributed to this person
Charged
360.00
Total submitted
Denied
360.00
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 | LEILA DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000434 |
| Date of birth | 30 Sep 1981 |
| Plan | GOLD PPO |
| Covered from | 23 Mar 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0001834 | 11 Aug 2026 | 191.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 191.00 |
| CLM0001833 | 19 Oct 2025 | 169.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 169.00 |