AMARA LOPEZ
Subscriber on policy B05M000177
Claims
2
Attributed to this person
Charged
748.00
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 | AMARA LOPEZ |
| Role on the policy | Subscriber |
| Policy | B05M000177 |
| Date of birth | 6 Jun 1960 |
| Plan | SILVER HMO |
| Covered from | 25 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 |
|---|---|---|---|---|---|
| CLM0000740 | 21 May 2026 | 302.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000741 | 19 Feb 2026 | 446.00 | NORTHSTAR MUTUAL | Not denied | — |