JULIA DIAZ
Subscriber on policy B10M000665
Claims
1
Attributed to this person
Charged
778.00
Total submitted
Denied
235.65
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 | JULIA DIAZ |
| Role on the policy | Subscriber |
| Policy | B10M000665 |
| Date of birth | 3 Sep 2000 |
| Plan | SILVER HMO |
| Covered from | 26 Apr 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 |
|---|---|---|---|---|---|
| CLM0002764 | 6 Aug 2026 | 778.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 235.65 |