AMARA LOPEZ
Dependent on policy B10M000868
Claims
3
Attributed to this person
Charged
1,047.00
Total submitted
Denied
233.00
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 | AMARA LOPEZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000868 |
| Date of birth | 16 Oct 1986 |
| Plan | BRONZE EPO |
| Covered from | 5 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 |
|---|---|---|---|---|---|
| CLM0003682 | 21 Feb 2026 | 233.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 233.00 |
| CLM0003683 | 9 Sep 2025 | 662.00 | CASCADE CARE | Not denied | — |
| CLM0003684 | 17 Jul 2025 | 152.00 | CASCADE CARE | Not denied | — |