ZARA HUGHES
Dependent on policy B06M000130
Claims
2
Attributed to this person
Charged
1,188.00
Total submitted
Denied
509.00
2 denied claims
Patient responsibility
441.35
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 | ZARA HUGHES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000130 |
| Date of birth | 26 Sep 1998 |
| Plan | PLATINUM PPO |
| Covered from | 28 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 441.35 |
| Total | 441.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000638 | 4 Dec 2025 | 679.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0000637 | 2 Oct 2024 | 509.00 | CASCADE CARE | CARC 11 · CODING | 509.00 |