YUSUF LOPEZ
Dependent on policy B07M000683
Claims
3
Attributed to this person
Charged
1,011.00
Total submitted
Denied
871.00
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 | YUSUF LOPEZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000683 |
| Date of birth | 20 Oct 1988 |
| Plan | BRONZE EPO |
| Covered from | 14 Jun 2025 |
| Covered to | 24 Jan 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002841 | 14 Mar 2026 | 342.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 342.00 |
| CLM0002842 | 3 Dec 2025 | 529.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 529.00 |
| CLM0002840 | 13 Aug 2025 | 140.00 | MERIDIAN HEALTH PLAN | Not denied | — |