DAVID DIAZ
Dependent on policy B02M000805
Claims
3
Attributed to this person
Charged
904.00
Total submitted
Denied
358.00
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 | DAVID DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000805 |
| Date of birth | 6 Feb 1993 |
| Plan | SILVER HMO |
| Covered from | 7 May 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003358 | 24 Aug 2026 | 273.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003359 | 17 Nov 2025 | 358.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 358.00 |
| CLM0003360 | 1 Nov 2025 | 273.00 | NORTHSTAR MUTUAL | Not denied | — |