HENRY LOPEZ
Subscriber on policy B08M000035
Claims
2
Attributed to this person
Charged
443.00
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 | Subscriber |
| Policy | B08M000035 |
| Date of birth | 6 Jul 1986 |
| Plan | BRONZE EPO |
| Covered from | 29 Jul 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 |
|---|---|---|---|---|---|
| CLM0000144 | 29 Jul 2026 | 213.00 | CASCADE CARE | Not denied | — |
| CLM0000145 | 28 Aug 2024 | 230.00 | CASCADE CARE | Not denied | — |