SOFIA LOPEZ
Dependent on policy B07M000070
Claims
3
Attributed to this person
Charged
1,571.00
Total submitted
Denied
202.00
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 | SOFIA LOPEZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000070 |
| Date of birth | 26 Jun 2010 |
| Plan | BRONZE EPO |
| Covered from | 17 Apr 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 |
|---|---|---|---|---|---|
| CLM0000301 | 4 Mar 2026 | 566.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000300 | 16 Sep 2025 | 202.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 202.00 |
| CLM0000299 | 7 Aug 2025 | 803.00 | MERIDIAN HEALTH PLAN | Not denied | — |