GRACE DIAZ
Subscriber on policy B01M000519
Claims
2
Attributed to this person
Charged
959.00
Total submitted
Denied
959.00
2 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 | GRACE DIAZ |
| Role on the policy | Subscriber |
| Policy | B01M000519 |
| Date of birth | 6 Feb 1954 |
| Plan | SILVER HMO |
| Covered from | 25 Apr 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0002340 | 14 May 2026 | 665.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 665.00 |
| CLM0002341 | 6 Mar 2026 | 294.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 294.00 |