ZARA LOPEZ
Subscriber on policy B06M000517
Claims
2
Attributed to this person
Charged
1,156.00
Total submitted
Denied
695.00
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 | ZARA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B06M000517 |
| Date of birth | 31 Jan 1986 |
| Plan | BRONZE EPO |
| Covered from | 22 May 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 |
|---|---|---|---|---|---|
| CLM0002302 | 11 Jul 2026 | 461.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002303 | 7 May 2025 | 695.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 695.00 |