HENRY HUGHES
Subscriber on policy B08M000852
Claims
3
Attributed to this person
Charged
1,461.00
Total submitted
Denied
178.53
1 denied claims
Patient responsibility
28.40
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 | HENRY HUGHES |
| Role on the policy | Subscriber |
| Policy | B08M000852 |
| Date of birth | 15 Nov 1963 |
| Plan | BRONZE EPO |
| Covered from | 30 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 28.40 |
| Total | 28.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003816 | 3 Jul 2025 | 142.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003814 | 13 Mar 2025 | 841.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003815 | 18 Feb 2025 | 478.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 178.53 |