AMARA LOPEZ
Subscriber on policy B07M000272
Claims
1
Attributed to this person
Charged
236.00
Total submitted
Denied
236.00
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 | AMARA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B07M000272 |
| Date of birth | 13 Jun 2000 |
| Plan | SILVER HMO |
| Covered from | 18 Oct 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 |
|---|---|---|---|---|---|
| CLM0001173 | 24 Mar 2025 | 236.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 236.00 |