YUSUF DIAZ
Subscriber on policy B02M000439
Claims
2
Attributed to this person
Charged
1,368.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
104.55
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 | YUSUF DIAZ |
| Role on the policy | Subscriber |
| Policy | B02M000439 |
| Date of birth | 3 Aug 1967 |
| Plan | SILVER HMO |
| Covered from | 10 May 2025 |
| Covered to | 21 Dec 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 104.55 |
| Total | 104.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001871 | 26 Nov 2025 | 671.00 | CASCADE CARE | Not denied | — |
| CLM0001872 | 30 Apr 2025 | 697.00 | CASCADE CARE | Not denied | — |