PRIYA DIAZ
Dependent on policy B10M000120
Claims
3
Attributed to this person
Charged
1,597.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
134.55
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 | PRIYA DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000120 |
| Date of birth | 21 Jun 1947 |
| Plan | PLATINUM PPO |
| Covered from | 6 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 134.55 |
| Total | 134.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000505 | 31 Jan 2026 | 897.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000503 | 30 Jul 2025 | 187.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000504 | 2 May 2025 | 513.00 | MERIDIAN HEALTH PLAN | Not denied | — |