HENRY LOPEZ
Dependent on policy B06M000037
Claims
2
Attributed to this person
Charged
484.00
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 | HENRY LOPEZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000037 |
| Date of birth | 9 Dec 2010 |
| 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 |
|---|---|---|---|---|---|
| CLM0000213 | 30 Jul 2026 | 265.00 | CASCADE CARE | Not denied | — |
| CLM0000214 | 9 Jul 2026 | 219.00 | CASCADE CARE | Not denied | — |