KEVIN DIAZ
Dependent on policy B08M000683
Claims
2
Attributed to this person
Charged
1,413.00
Total submitted
Denied
622.00
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 | KEVIN DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000683 |
| Date of birth | 11 Jan 1986 |
| Plan | SILVER HMO |
| Covered from | 12 Mar 2025 |
| Covered to | 25 Sep 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 |
|---|---|---|---|---|---|
| CLM0003085 | 3 Jun 2025 | 791.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003086 | 6 Mar 2025 | 622.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 622.00 |