CARLA DIAZ
Subscriber on policy B02M000697
Claims
3
Attributed to this person
Charged
1,095.00
Total submitted
Denied
685.00
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 | CARLA DIAZ |
| Role on the policy | Subscriber |
| Policy | B02M000697 |
| Date of birth | 28 Nov 1952 |
| Plan | GOLD PPO |
| Covered from | 4 Dec 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 |
|---|---|---|---|---|---|
| CLM0002936 | 20 Oct 2025 | 322.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002937 | 2 Apr 2025 | 88.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002935 | 23 Nov 2024 | 685.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 685.00 |