OMAR DIAZ
Dependent on policy B05M000254
Claims
3
Attributed to this person
Charged
1,847.00
Total submitted
Denied
799.50
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 | OMAR DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000254 |
| Date of birth | 16 Mar 2007 |
| Plan | SILVER HMO |
| Covered from | 22 Jan 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 |
|---|---|---|---|---|---|
| CLM0001036 | 29 Jun 2026 | 502.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001037 | 23 Aug 2025 | 825.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 279.50 |
| CLM0001038 | 9 Jan 2025 | 520.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 520.00 |