ZARA DIAZ
Subscriber on policy B03M000521
Claims
3
Attributed to this person
Charged
835.00
Total submitted
Denied
393.00
1 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 | ZARA DIAZ |
| Role on the policy | Subscriber |
| Policy | B03M000521 |
| Date of birth | 2 Sep 1999 |
| Plan | BRONZE EPO |
| Covered from | 15 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 |
|---|---|---|---|---|---|
| CLM0002136 | 28 Aug 2026 | 282.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002135 | 26 Apr 2026 | 160.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002137 | 2 Sep 2025 | 393.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 393.00 |