DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B01M000084›JULIA LOPEZ

JULIA LOPEZ

Subscriber on policy B01M000084

Claims
1
Attributed to this person
Charged
511.00
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
NameJULIA LOPEZ
Role on the policySubscriber
PolicyB01M000084
Date of birth14 Jun 1984
PlanBRONZE EPO
Covered from5 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00003361 Aug 2025511.00MERIDIAN HEALTH PLANNot denied—