LEILA DIAZ
Subscriber on policy B01M000704
Claims
2
Attributed to this person
Charged
276.00
Total submitted
Denied
0.00
0 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 | B01M000704 |
| Date of birth | 30 Jul 1969 |
| Plan | SILVER HMO |
| Covered from | 27 Jan 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 |
|---|---|---|---|---|---|
| CLM0003144 | 22 Apr 2026 | 77.00 | CASCADE CARE | Not denied | — |
| CLM0003143 | 22 Sep 2024 | 199.00 | CASCADE CARE | Not denied | — |