NADIA LOPEZ
Dependent on policy B08M000866
Claims
2
Attributed to this person
Charged
1,044.00
Total submitted
Denied
588.00
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 | NADIA LOPEZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000866 |
| Date of birth | 16 Feb 1981 |
| Plan | PLATINUM PPO |
| Covered from | 16 Apr 2025 |
| Covered to | 22 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003883 | 19 Apr 2025 | 588.00 | CASCADE CARE | CARC 18 · DUPLICATE | 588.00 |
| CLM0003882 | 4 Apr 2025 | 456.00 | CASCADE CARE | Not denied | — |