MARCUS DIAZ
Subscriber on policy B10M000698
Claims
3
Attributed to this person
Charged
1,044.00
Total submitted
Denied
94.00
1 denied claims
Patient responsibility
54.45
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 | MARCUS DIAZ |
| Role on the policy | Subscriber |
| Policy | B10M000698 |
| Date of birth | 4 Jun 1953 |
| Plan | SILVER HMO |
| Covered from | 1 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 54.45 |
| Total | 54.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002925 | 14 Jul 2025 | 587.00 | CASCADE CARE | Not denied | — |
| CLM0002923 | 5 Mar 2025 | 363.00 | CASCADE CARE | Not denied | — |
| CLM0002924 | 26 Jul 2024 | 94.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 94.00 |