ELENA LOPEZ
Subscriber on policy B07M000201
Claims
2
Attributed to this person
Charged
611.00
Total submitted
Denied
611.00
2 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 | ELENA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B07M000201 |
| Date of birth | 15 Jul 1961 |
| Plan | BRONZE EPO |
| Covered from | 30 Nov 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 |
|---|---|---|---|---|---|
| CLM0000835 | 1 Jan 2026 | 440.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 440.00 |
| CLM0000836 | 17 Jul 2025 | 171.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 171.00 |