SOFIA HUGHES
Subscriber on policy B07M000235
Claims
3
Attributed to this person
Charged
1,888.00
Total submitted
Denied
86.49
1 denied claims
Patient responsibility
115.65
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 | SOFIA HUGHES |
| Role on the policy | Subscriber |
| Policy | B07M000235 |
| Date of birth | 15 Nov 1955 |
| Plan | PLATINUM PPO |
| Covered from | 8 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 115.65 |
| Total | 115.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000995 | 25 Mar 2026 | 771.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000993 | 24 Sep 2024 | 257.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 86.49 |
| CLM0000994 | 14 Jul 2024 | 860.00 | NORTHSTAR MUTUAL | Not denied | — |