LEILA DIAZ
Dependent on policy B10M000504
Claims
3
Attributed to this person
Charged
1,227.00
Total submitted
Denied
217.00
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 | Dependent · relationship 01 |
| Policy | B10M000504 |
| Date of birth | 13 Jun 1986 |
| Plan | GOLD PPO |
| Covered from | 19 Jul 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 |
|---|---|---|---|---|---|
| CLM0002072 | 14 May 2026 | 217.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 217.00 |
| CLM0002073 | 27 Mar 2026 | 749.00 | CASCADE CARE | Not denied | — |
| CLM0002071 | 29 Jun 2024 | 261.00 | CASCADE CARE | Not denied | — |