WENDY DIAZ
Subscriber on policy B09M000875
Claims
3
Attributed to this person
Charged
2,216.00
Total submitted
Denied
1,423.00
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 | WENDY DIAZ |
| Role on the policy | Subscriber |
| Policy | B09M000875 |
| Date of birth | 24 Apr 1960 |
| Plan | PLATINUM PPO |
| Covered from | 12 Jan 2025 |
| Covered to | 19 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003711 | 24 Apr 2025 | 793.00 | CASCADE CARE | Not denied | — |
| CLM0003710 | 5 Jan 2025 | 830.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 830.00 |
| CLM0003709 | 13 Dec 2024 | 593.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 593.00 |