DAVID DIAZ
Subscriber on policy B05M000282
Claims
2
Attributed to this person
Charged
738.00
Total submitted
Denied
245.00
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 | DAVID DIAZ |
| Role on the policy | Subscriber |
| Policy | B05M000282 |
| Date of birth | 20 Mar 1973 |
| Plan | SILVER HMO |
| Covered from | 18 Aug 2024 |
| Covered to | 16 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001163 | 23 May 2025 | 245.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 245.00 |
| CLM0001164 | 7 May 2025 | 493.00 | CASCADE CARE | Not denied | — |