CARLA LOPEZ
Subscriber on policy B06M000037
Claims
2
Attributed to this person
Charged
900.00
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 | CARLA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B06M000037 |
| Date of birth | 14 Dec 1982 |
| Plan | BRONZE EPO |
| Covered from | 6 Feb 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 |
|---|---|---|---|---|---|
| CLM0000206 | 8 May 2025 | 769.00 | CASCADE CARE | Not denied | — |
| CLM0000207 | 9 Jan 2025 | 131.00 | CASCADE CARE | Not denied | — |