WENDY DIAZ
Subscriber on policy B04M000296
Claims
2
Attributed to this person
Charged
678.00
Total submitted
Denied
281.00
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 | WENDY DIAZ |
| Role on the policy | Subscriber |
| Policy | B04M000296 |
| Date of birth | 4 Mar 1995 |
| Plan | BRONZE EPO |
| Covered from | 25 May 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 |
|---|---|---|---|---|---|
| CLM0001277 | 25 Apr 2026 | 397.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001276 | 12 Jan 2026 | 281.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 281.00 |