UMA LOPEZ
Subscriber on policy B06M000242
Claims
1
Attributed to this person
Charged
86.00
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
| Field | Value |
|---|---|
| Name | UMA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B06M000242 |
| Date of birth | 22 May 1952 |
| Plan | PLATINUM PPO |
| Covered from | 26 May 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 |
|---|---|---|---|---|---|
| CLM0001145 | 31 Dec 2024 | 86.00 | MERIDIAN HEALTH PLAN | Not denied | — |