RAVI DIAZ
Subscriber on policy B05M000256
Claims
1
Attributed to this person
Charged
180.00
Total submitted
Denied
180.00
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 | Subscriber |
| Policy | B05M000256 |
| Date of birth | 5 Apr 1965 |
| Plan | PLATINUM PPO |
| Covered from | 9 Nov 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 |
|---|---|---|---|---|---|
| CLM0001051 | 6 Oct 2025 | 180.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 180.00 |