FIONA LOPEZ
Subscriber on policy B08M000364
Claims
2
Attributed to this person
Charged
1,110.00
Total submitted
Denied
896.00
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 | FIONA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B08M000364 |
| Date of birth | 14 Feb 1966 |
| Plan | PLATINUM PPO |
| Covered from | 27 Jan 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 |
|---|---|---|---|---|---|
| CLM0001659 | 7 Oct 2025 | 896.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 896.00 |
| CLM0001658 | 31 Aug 2024 | 214.00 | CASCADE CARE | Not denied | — |