WENDY LOPEZ
Subscriber on policy B10M000383
Claims
2
Attributed to this person
Charged
596.00
Total submitted
Denied
596.00
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 | WENDY LOPEZ |
| Role on the policy | Subscriber |
| Policy | B10M000383 |
| Date of birth | 31 Jan 1956 |
| Plan | SILVER HMO |
| Covered from | 24 Feb 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 |
|---|---|---|---|---|---|
| CLM0001593 | 13 Nov 2025 | 451.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 451.00 |
| CLM0001592 | 28 Jan 2025 | 145.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 145.00 |