GRACE DIAZ
Subscriber on policy B09M000844
Claims
2
Attributed to this person
Charged
932.00
Total submitted
Denied
218.85
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 | GRACE DIAZ |
| Role on the policy | Subscriber |
| Policy | B09M000844 |
| Date of birth | 10 Feb 1953 |
| Plan | BRONZE EPO |
| Covered from | 4 Jan 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 |
|---|---|---|---|---|---|
| CLM0003593 | 20 Jun 2026 | 460.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 218.85 |
| CLM0003592 | 11 Mar 2025 | 472.00 | CASCADE CARE | Not denied | — |