BRIAN DIAZ
Dependent on policy B04M000127
Claims
2
Attributed to this person
Charged
506.00
Total submitted
Denied
426.55
2 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 | BRIAN DIAZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000127 |
| Date of birth | 18 Aug 1965 |
| Plan | SILVER HMO |
| Covered from | 9 Aug 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 |
|---|---|---|---|---|---|
| CLM0000588 | 5 Jan 2026 | 139.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 59.55 |
| CLM0000587 | 22 Nov 2024 | 367.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 367.00 |