JULIA LOPEZ
Subscriber on policy B03M000651
Claims
3
Attributed to this person
Charged
1,138.00
Total submitted
Denied
288.00
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 | JULIA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B03M000651 |
| Date of birth | 21 Feb 1998 |
| Plan | BRONZE EPO |
| Covered from | 28 Sep 2024 |
| Covered to | 23 Jul 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 |
|---|---|---|---|---|---|
| CLM0002712 | 12 Aug 2025 | 288.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 288.00 |
| CLM0002711 | 8 Apr 2025 | 436.00 | CASCADE CARE | Not denied | — |
| CLM0002710 | 16 Dec 2024 | 414.00 | CASCADE CARE | Not denied | — |