JULIA DIAZ
Subscriber on policy B03M000154
Claims
1
Attributed to this person
Charged
427.00
Total submitted
Denied
427.00
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 | JULIA DIAZ |
| Role on the policy | Subscriber |
| Policy | B03M000154 |
| Date of birth | 3 Nov 1977 |
| Plan | PLATINUM PPO |
| Covered from | 2 Feb 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 |
|---|---|---|---|---|---|
| CLM0000627 | 3 Jun 2025 | 427.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 427.00 |