TOMAS HUGHES
Subscriber on policy B07M000073
Claims
1
Attributed to this person
Charged
208.00
Total submitted
Denied
208.00
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 | TOMAS HUGHES |
| Role on the policy | Subscriber |
| Policy | B07M000073 |
| Date of birth | 20 Sep 1992 |
| Plan | PLATINUM PPO |
| Covered from | 25 Jul 2024 |
| Covered to | 4 Jan 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000312 | 15 Aug 2024 | 208.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 208.00 |