SOFIA DIAZ
Subscriber on policy B03M000664
Claims
2
Attributed to this person
Charged
1,712.00
Total submitted
Denied
0.00
0 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 | SOFIA DIAZ |
| Role on the policy | Subscriber |
| Policy | B03M000664 |
| Date of birth | 8 Jan 1980 |
| Plan | PLATINUM PPO |
| Covered from | 2 Jun 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 |
|---|---|---|---|---|---|
| CLM0002756 | 10 Nov 2025 | 842.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002755 | 16 Oct 2025 | 870.00 | NORTHSTAR MUTUAL | Not denied | — |