LEILA DIAZ
Dependent on policy B02M000294
Claims
3
Attributed to this person
Charged
1,788.00
Total submitted
Denied
603.95
2 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 | LEILA DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000294 |
| Date of birth | 27 Oct 1970 |
| Plan | BRONZE EPO |
| Covered from | 9 Nov 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 |
|---|---|---|---|---|---|
| CLM0001271 | 18 Sep 2025 | 882.00 | CASCADE CARE | Not denied | — |
| CLM0001269 | 28 May 2025 | 548.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 245.95 |
| CLM0001270 | 17 Nov 2024 | 358.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 358.00 |