GRACE HUGHES
Subscriber on policy B07M000010
Claims
3
Attributed to this person
Charged
794.00
Total submitted
Denied
186.00
1 denied claims
Patient responsibility
121.60
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 | B07M000010 |
| Date of birth | 14 Nov 1979 |
| Plan | SILVER HMO |
| Covered from | 21 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 2 | 121.60 |
| Total | 121.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000058 | 27 May 2026 | 186.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 186.00 |
| CLM0000056 | 25 May 2026 | 379.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000057 | 23 Dec 2025 | 229.00 | NORTHSTAR MUTUAL | Not denied | — |