KEVIN DIAZ
Subscriber on policy B10M000855
Claims
2
Attributed to this person
Charged
1,137.00
Total submitted
Denied
395.00
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 | KEVIN DIAZ |
| Role on the policy | Subscriber |
| Policy | B10M000855 |
| Date of birth | 7 Dec 1956 |
| Plan | BRONZE EPO |
| Covered from | 14 Jun 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 |
|---|---|---|---|---|---|
| CLM0003617 | 4 Oct 2025 | 742.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003618 | 26 Jul 2024 | 395.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 395.00 |