JULIA LOPEZ
Dependent on policy B07M000419
Claims
2
Attributed to this person
Charged
636.00
Total submitted
Denied
192.00
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 | Dependent · relationship 19 |
| Policy | B07M000419 |
| Date of birth | 14 Sep 2007 |
| Plan | SILVER HMO |
| Covered from | 30 Mar 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 |
|---|---|---|---|---|---|
| CLM0001774 | 2 Apr 2025 | 444.00 | CASCADE CARE | Not denied | — |
| CLM0001773 | 23 Mar 2025 | 192.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 192.00 |