GRACE DIAZ
Subscriber on policy B10M000366
Claims
2
Attributed to this person
Charged
987.00
Total submitted
Denied
607.00
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 | GRACE DIAZ |
| Role on the policy | Subscriber |
| Policy | B10M000366 |
| Date of birth | 11 Sep 1987 |
| Plan | PLATINUM PPO |
| Covered from | 14 Mar 2025 |
| Covered to | 9 Aug 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 |
|---|---|---|---|---|---|
| CLM0001525 | 10 Sep 2025 | 607.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 607.00 |
| CLM0001524 | 5 Apr 2025 | 380.00 | MERIDIAN HEALTH PLAN | Not denied | — |