LEILA DIAZ
Dependent on policy B09M000768
Claims
3
Attributed to this person
Charged
2,131.00
Total submitted
Denied
869.00
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 | LEILA DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000768 |
| Date of birth | 28 Mar 2012 |
| Plan | PLATINUM PPO |
| Covered from | 17 Apr 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 |
|---|---|---|---|---|---|
| CLM0003257 | 28 May 2026 | 582.00 | CASCADE CARE | Not denied | — |
| CLM0003258 | 17 Sep 2025 | 680.00 | CASCADE CARE | Not denied | — |
| CLM0003256 | 4 Jun 2024 | 869.00 | CASCADE CARE | CARC 96 · NON_COVERED | 869.00 |