FIONA DIAZ
Subscriber on policy B03M000051
Claims
2
Attributed to this person
Charged
473.00
Total submitted
Denied
473.00
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 | FIONA DIAZ |
| Role on the policy | Subscriber |
| Policy | B03M000051 |
| Date of birth | 30 Jun 1955 |
| Plan | SILVER HMO |
| Covered from | 26 Apr 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 |
|---|---|---|---|---|---|
| CLM0000219 | 10 Jan 2026 | 285.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 285.00 |
| CLM0000218 | 29 Oct 2025 | 188.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 188.00 |