TOMAS DIAZ
Subscriber on policy B01M000312
Claims
3
Attributed to this person
Charged
1,665.00
Total submitted
Denied
259.78
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 | TOMAS DIAZ |
| Role on the policy | Subscriber |
| Policy | B01M000312 |
| Date of birth | 18 Nov 1984 |
| Plan | BRONZE EPO |
| Covered from | 22 Feb 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 |
|---|---|---|---|---|---|
| CLM0001386 | 13 Nov 2025 | 361.00 | CASCADE CARE | Not denied | — |
| CLM0001385 | 3 Sep 2024 | 409.00 | CASCADE CARE | Not denied | — |
| CLM0001387 | 14 Jul 2024 | 895.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 259.78 |