NADIA DIAZ
Dependent on policy B10M000051
Claims
2
Attributed to this person
Charged
1,413.00
Total submitted
Denied
595.00
1 denied claims
Patient responsibility
50.00
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 | NADIA DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000051 |
| Date of birth | 16 Oct 2003 |
| Plan | BRONZE EPO |
| Covered from | 19 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000205 | 16 Nov 2025 | 818.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000206 | 10 Feb 2025 | 595.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 595.00 |