IVAN DIAZ
Subscriber on policy B02M000675
Claims
3
Attributed to this person
Charged
906.00
Total submitted
Denied
76.00
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 | IVAN DIAZ |
| Role on the policy | Subscriber |
| Policy | B02M000675 |
| Date of birth | 25 Oct 1958 |
| Plan | PLATINUM PPO |
| Covered from | 15 Mar 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 |
|---|---|---|---|---|---|
| CLM0002852 | 27 Jan 2026 | 549.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002854 | 4 Dec 2024 | 76.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 76.00 |
| CLM0002853 | 4 Nov 2024 | 281.00 | NORTHSTAR MUTUAL | Not denied | — |