LEILA DIAZ
Dependent on policy B02M000439
Claims
3
Attributed to this person
Charged
1,795.00
Total submitted
Denied
960.00
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 19 |
| Policy | B02M000439 |
| Date of birth | 27 Mar 1996 |
| Plan | SILVER HMO |
| Covered from | 10 May 2025 |
| Covered to | 21 Dec 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001876 | 3 Dec 2025 | 809.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 809.00 |
| CLM0001874 | 29 Nov 2025 | 151.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 151.00 |
| CLM0001875 | 29 Nov 2025 | 835.00 | CASCADE CARE | Not denied | — |