VICTOR DIAZ
Dependent on policy B07M000028
Claims
3
Attributed to this person
Charged
1,474.00
Total submitted
Denied
273.00
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 | VICTOR DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000028 |
| Date of birth | 27 Apr 1986 |
| Plan | PLATINUM PPO |
| Covered from | 8 Feb 2025 |
| Covered to | 9 Aug 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000124 | 22 Sep 2025 | 273.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 273.00 |
| CLM0000126 | 1 Aug 2025 | 900.00 | CASCADE CARE | Not denied | — |
| CLM0000125 | 6 Apr 2025 | 301.00 | CASCADE CARE | Not denied | — |