MARCUS LOPEZ
Subscriber on policy B05M000879
Claims
3
Attributed to this person
Charged
1,749.00
Total submitted
Denied
379.00
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 | MARCUS LOPEZ |
| Role on the policy | Subscriber |
| Policy | B05M000879 |
| Date of birth | 13 Nov 1966 |
| Plan | SILVER HMO |
| Covered from | 16 May 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 |
|---|---|---|---|---|---|
| CLM0003726 | 21 Jul 2025 | 597.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003727 | 6 May 2025 | 773.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003728 | 10 Jun 2024 | 379.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 379.00 |