LEILA HUGHES
Dependent on policy B07M000049
Claims
2
Attributed to this person
Charged
1,157.00
Total submitted
Denied
315.00
1 denied claims
Patient responsibility
168.40
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 | LEILA HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000049 |
| Date of birth | 1 Feb 2003 |
| Plan | PLATINUM PPO |
| Covered from | 24 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 168.40 |
| Total | 168.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000238 | 10 Jan 2026 | 842.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000239 | 3 May 2025 | 315.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 315.00 |