ZARA DIAZ
Dependent on policy B08M000472
Claims
3
Attributed to this person
Charged
1,544.00
Total submitted
Denied
749.00
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 | ZARA DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000472 |
| Date of birth | 29 Sep 2014 |
| Plan | BRONZE EPO |
| Covered from | 3 Jan 2025 |
| Covered to | 13 Mar 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 |
|---|---|---|---|---|---|
| CLM0002187 | 15 Apr 2025 | 306.00 | CASCADE CARE | Not denied | — |
| CLM0002189 | 17 Mar 2025 | 489.00 | CASCADE CARE | Not denied | — |
| CLM0002188 | 15 Feb 2025 | 749.00 | CASCADE CARE | CARC 18 · DUPLICATE | 749.00 |