UMA LOPEZ
Dependent on policy B06M000427
Claims
3
Attributed to this person
Charged
1,760.00
Total submitted
Denied
212.07
1 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 | Dependent · relationship 01 |
| Policy | B06M000427 |
| Date of birth | 21 Apr 1977 |
| Plan | BRONZE EPO |
| Covered from | 16 Jun 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 |
|---|---|---|---|---|---|
| CLM0001964 | 27 Aug 2025 | 125.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001965 | 7 Mar 2025 | 891.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001963 | 29 Jan 2025 | 744.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 212.07 |