SOFIA LOPEZ
Subscriber on policy B06M000192
Claims
2
Attributed to this person
Charged
706.00
Total submitted
Denied
0.00
0 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 | SOFIA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B06M000192 |
| Date of birth | 28 Aug 1973 |
| Plan | SILVER HMO |
| Covered from | 9 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 |
|---|---|---|---|---|---|
| CLM0000931 | 30 Mar 2026 | 564.00 | CASCADE CARE | Not denied | — |
| CLM0000932 | 12 Aug 2024 | 142.00 | CASCADE CARE | Not denied | — |