JULIA LOPEZ
Subscriber on policy B01M000543
Claims
1
Attributed to this person
Charged
895.00
Total submitted
Denied
895.00
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 | JULIA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B01M000543 |
| Date of birth | 19 Mar 1955 |
| Plan | BRONZE EPO |
| Covered from | 28 Mar 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 |
|---|---|---|---|---|---|
| CLM0002443 | 7 Jun 2026 | 895.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 895.00 |