MARCUS LOPEZ
Dependent on policy B07M000201
Claims
2
Attributed to this person
Charged
308.00
Total submitted
Denied
308.00
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 | MARCUS LOPEZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000201 |
| Date of birth | 8 Mar 1998 |
| 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 |
|---|---|---|---|---|---|
| CLM0000841 | 29 Mar 2025 | 206.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 206.00 |
| CLM0000840 | 2 Jan 2025 | 102.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 102.00 |