OMAR HUGHES
Dependent on policy B01M000322
Claims
3
Attributed to this person
Charged
695.00
Total submitted
Denied
335.97
2 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 | OMAR HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000322 |
| Date of birth | 21 Jan 2018 |
| Plan | BRONZE EPO |
| Covered from | 30 Dec 2024 |
| Covered to | 25 Sep 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 |
|---|---|---|---|---|---|
| CLM0001435 | 16 Sep 2025 | 221.00 | CASCADE CARE | CARC 18 · DUPLICATE | 221.00 |
| CLM0001436 | 17 Aug 2025 | 315.00 | CASCADE CARE | CARC 96 · NON_COVERED | 114.97 |
| CLM0001434 | 18 Jun 2025 | 159.00 | CASCADE CARE | Not denied | — |