JULIA LOPEZ
Dependent on policy B01M000292
Claims
3
Attributed to this person
Charged
938.00
Total submitted
Denied
806.00
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 | JULIA LOPEZ |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000292 |
| Date of birth | 11 Aug 1965 |
| Plan | BRONZE EPO |
| Covered from | 7 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 |
|---|---|---|---|---|---|
| CLM0001280 | 30 Aug 2025 | 132.00 | CASCADE CARE | Not denied | — |
| CLM0001282 | 28 Apr 2024 | 339.00 | CASCADE CARE | CARC 11 · CODING | 339.00 |
| CLM0001281 | 17 Apr 2024 | 467.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 467.00 |