LEILA DIAZ
Subscriber on policy B01M000047
Claims
3
Attributed to this person
Charged
653.00
Total submitted
Denied
483.00
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 | Subscriber |
| Policy | B01M000047 |
| Date of birth | 19 Jul 1969 |
| Plan | SILVER HMO |
| Covered from | 17 Apr 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 |
|---|---|---|---|---|---|
| CLM0000184 | 4 Mar 2025 | 170.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000183 | 1 Jun 2024 | 191.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 191.00 |
| CLM0000182 | 15 Apr 2024 | 292.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 292.00 |