X12 Ingest & Denial Analytics

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Members›policy B07M000328›SOFIA DIAZ

SOFIA DIAZ

Subscriber on policy B07M000328

Claims
2
Attributed to this person
Charged
1,343.00
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

FieldValue
NameSOFIA DIAZ
Role on the policySubscriber
PolicyB07M000328
Date of birth13 Nov 1970
PlanGOLD PPO
Covered from30 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00014025 Feb 2026459.00MERIDIAN HEALTH PLANNot denied—
CLM000140121 Oct 2025884.00MERIDIAN HEALTH PLANNot denied—