UMA DIAZ
Dependent on policy B04M000827
Claims
3
Attributed to this person
Charged
1,597.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
86.70
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 | UMA DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000827 |
| Date of birth | 11 Sep 1996 |
| Plan | PLATINUM PPO |
| Covered from | 27 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 86.70 |
| Total | 86.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003587 | 11 Mar 2026 | 551.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003585 | 5 May 2025 | 578.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003586 | 15 May 2024 | 468.00 | MERIDIAN HEALTH PLAN | Not denied | — |