LEILA DIAZ
Subscriber on policy B01M000656
Claims
2
Attributed to this person
Charged
1,489.00
Total submitted
Denied
820.00
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 | LEILA DIAZ |
| Role on the policy | Subscriber |
| Policy | B01M000656 |
| Date of birth | 7 Sep 1996 |
| Plan | PLATINUM PPO |
| Covered from | 22 Feb 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002934 | 4 Nov 2024 | 669.00 | CASCADE CARE | Not denied | — |
| CLM0002933 | 3 Feb 2024 | 820.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 820.00 |