DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.

ZARA DIAZ

Subscriber on policy B10M000521

Claims
1
Attributed to this person
Charged
438.00
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

FieldValue
NameZARA DIAZ
Role on the policySubscriber
PolicyB10M000521
Date of birth25 Aug 1989
PlanSILVER HMO
Covered from13 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000214618 May 2025438.00CASCADE CARENot denied—