X12 Ingest & Denial Analytics

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Members›policy B01M000369›JULIA DIAZ

JULIA DIAZ

Dependent on policy B01M000369

Claims
3
Attributed to this person
Charged
1,301.00
Total submitted
Denied
1,301.00
3 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
NameJULIA DIAZ
Role on the policyDependent · relationship 01
PolicyB01M000369
Date of birth27 Mar 1966
PlanSILVER HMO
Covered from12 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00016418 Jul 2026104.00MERIDIAN HEALTH PLANCARC 16 · BILLING_ERROR104.00
CLM000163910 Nov 2025577.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE577.00
CLM000164012 Jun 2025620.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY620.00