HENRY HUGHES
Dependent on policy B09M000744
Claims
1
Attributed to this person
Charged
114.00
Total submitted
Denied
114.00
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 | HENRY HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000744 |
| Date of birth | 16 Jun 2008 |
| Plan | SILVER HMO |
| Covered from | 3 Oct 2024 |
| Covered to | 5 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 |
|---|---|---|---|---|---|
| CLM0003152 | 17 Jan 2025 | 114.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 114.00 |