NADIA LOPEZ
Subscriber on policy B01M000619
Claims
2
Attributed to this person
Charged
379.00
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 | NADIA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B01M000619 |
| Date of birth | 11 Jul 1957 |
| Plan | SILVER HMO |
| Covered from | 6 Jan 2025 |
| Covered to | 27 Aug 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 |
|---|---|---|---|---|---|
| CLM0002764 | 21 Jul 2025 | 136.00 | CASCADE CARE | Not denied | — |
| CLM0002765 | 28 Mar 2025 | 243.00 | CASCADE CARE | Not denied | — |