X12 Ingest & Denial Analytics

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Members›policy B05M000049›NADIA LOPEZ

NADIA LOPEZ

Dependent on policy B05M000049

Claims
3
Attributed to this person
Charged
1,991.00
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
NameNADIA LOPEZ
Role on the policyDependent · relationship 19
PolicyB05M000049
Date of birth17 Mar 2009
PlanGOLD PPO
Covered from12 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00002335 May 2026575.00MERIDIAN HEALTH PLANNot denied—
CLM000023215 Jan 2025631.00MERIDIAN HEALTH PLANNot denied—
CLM000023119 Nov 2024785.00MERIDIAN HEALTH PLANNot denied—