GRACE HUGHES
Subscriber on policy B06M000419
Claims
3
Attributed to this person
Charged
1,418.00
Total submitted
Denied
291.00
1 denied claims
Patient responsibility
107.40
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 | GRACE HUGHES |
| Role on the policy | Subscriber |
| Policy | B06M000419 |
| Date of birth | 8 Feb 1955 |
| Plan | PLATINUM PPO |
| Covered from | 11 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 107.40 |
| Total | 107.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001923 | 28 Nov 2025 | 716.00 | CASCADE CARE | Not denied | — |
| CLM0001922 | 19 Oct 2025 | 411.00 | CASCADE CARE | Not denied | — |
| CLM0001924 | 2 Jul 2024 | 291.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 291.00 |