OMAR DIAZ
Dependent on policy B08M000446
Claims
1
Attributed to this person
Charged
614.00
Total submitted
Denied
0.00
0 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 | OMAR DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000446 |
| Date of birth | 6 Mar 2003 |
| Plan | BRONZE EPO |
| Covered from | 23 Mar 2025 |
| Covered to | 20 Jul 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 |
|---|---|---|---|---|---|
| CLM0002058 | 27 May 2025 | 614.00 | CASCADE CARE | Not denied | — |