RAVI DIAZ
Dependent on policy B05M000828
Claims
2
Attributed to this person
Charged
1,239.00
Total submitted
Denied
738.00
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 | RAVI DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000828 |
| Date of birth | 18 May 1990 |
| Plan | PLATINUM PPO |
| Covered from | 11 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 |
|---|---|---|---|---|---|
| CLM0003519 | 9 Jan 2026 | 738.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 738.00 |
| CLM0003518 | 3 Aug 2025 | 501.00 | MERIDIAN HEALTH PLAN | Not denied | — |