RAVI DIAZ
Dependent on policy B09M000193
Claims
2
Attributed to this person
Charged
1,336.00
Total submitted
Denied
753.00
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 | RAVI DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000193 |
| Date of birth | 26 Sep 2018 |
| Plan | BRONZE EPO |
| Covered from | 28 Mar 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 |
|---|---|---|---|---|---|
| CLM0000805 | 2 Jan 2026 | 753.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 753.00 |
| CLM0000804 | 9 Aug 2025 | 583.00 | MERIDIAN HEALTH PLAN | Not denied | — |