NADIA LOPEZ
Subscriber on policy B03M000335
Claims
3
Attributed to this person
Charged
1,473.00
Total submitted
Denied
327.91
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 | NADIA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B03M000335 |
| Date of birth | 14 Jan 1966 |
| Plan | SILVER HMO |
| Covered from | 8 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001341 | 9 Jun 2026 | 332.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 140.70 |
| CLM0001340 | 29 May 2026 | 874.00 | CASCADE CARE | CARC 11 · CODING | 187.21 |
| CLM0001342 | 24 May 2026 | 267.00 | CASCADE CARE | Not denied | — |