MARCUS HUGHES
Subscriber on policy B01M000521
Claims
1
Attributed to this person
Charged
469.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
20.00
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 HUGHES |
| Role on the policy | Subscriber |
| Policy | B01M000521 |
| Date of birth | 5 Dec 1962 |
| Plan | GOLD PPO |
| Covered from | 13 Jun 2024 |
| Covered to | 17 Jan 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002348 | 16 Mar 2025 | 469.00 | NORTHSTAR MUTUAL | Not denied | — |