BRIAN HUGHES
Dependent on policy B01M000322
Claims
3
Attributed to this person
Charged
1,443.00
Total submitted
Denied
789.00
1 denied claims
Patient responsibility
33.15
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 | BRIAN HUGHES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000322 |
| Date of birth | 29 May 1976 |
| Plan | BRONZE EPO |
| Covered from | 30 Dec 2024 |
| Covered to | 25 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 33.15 |
| Total | 33.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001430 | 2 Sep 2025 | 433.00 | CASCADE CARE | Not denied | — |
| CLM0001428 | 16 Jun 2025 | 789.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 789.00 |
| CLM0001429 | 6 Mar 2025 | 221.00 | CASCADE CARE | Not denied | — |