AMARA DIAZ
Dependent on policy B05M000340
Claims
2
Attributed to this person
Charged
716.00
Total submitted
Denied
44.38
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 | AMARA DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000340 |
| Date of birth | 6 Feb 2004 |
| Plan | GOLD PPO |
| Covered from | 29 May 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 |
|---|---|---|---|---|---|
| CLM0001451 | 15 Aug 2025 | 135.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 44.38 |
| CLM0001450 | 29 May 2025 | 581.00 | CASCADE CARE | Not denied | — |