DAVID HUGHES
Subscriber on policy B07M000817
Claims
1
Attributed to this person
Charged
644.00
Total submitted
Denied
644.00
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 | DAVID HUGHES |
| Role on the policy | Subscriber |
| Policy | B07M000817 |
| Date of birth | 27 Jan 1982 |
| Plan | SILVER HMO |
| Covered from | 25 Apr 2024 |
| Covered to | 14 Feb 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 |
|---|---|---|---|---|---|
| CLM0003349 | 5 Jul 2024 | 644.00 | CASCADE CARE | CARC 96 · NON_COVERED | 644.00 |