NADIA LOPEZ
Subscriber on policy B07M000748
Claims
2
Attributed to this person
Charged
589.00
Total submitted
Denied
589.00
2 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 | NADIA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B07M000748 |
| Date of birth | 13 Oct 1951 |
| Plan | BRONZE EPO |
| Covered from | 10 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 |
|---|---|---|---|---|---|
| CLM0003091 | 14 Mar 2026 | 231.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 231.00 |
| CLM0003092 | 2 Nov 2025 | 358.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 358.00 |