WENDY LOPEZ
Dependent on policy B02M000603
Claims
3
Attributed to this person
Charged
1,672.00
Total submitted
Denied
481.00
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 | WENDY LOPEZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000603 |
| Date of birth | 25 Jul 2012 |
| Plan | SILVER HMO |
| Covered from | 24 Dec 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 |
|---|---|---|---|---|---|
| CLM0002538 | 20 Nov 2025 | 662.00 | CASCADE CARE | Not denied | — |
| CLM0002539 | 21 Oct 2025 | 481.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 481.00 |
| CLM0002537 | 21 Aug 2025 | 529.00 | CASCADE CARE | Not denied | — |