LEILA DIAZ
Subscriber on policy B07M000482
Claims
2
Attributed to this person
Charged
754.00
Total submitted
Denied
202.00
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 | LEILA DIAZ |
| Role on the policy | Subscriber |
| Policy | B07M000482 |
| Date of birth | 27 Oct 1982 |
| Plan | PLATINUM PPO |
| Covered from | 6 Nov 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 |
|---|---|---|---|---|---|
| CLM0002054 | 7 May 2025 | 552.00 | CASCADE CARE | Not denied | — |
| CLM0002055 | 19 Mar 2025 | 202.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 202.00 |