LEILA HUGHES
Subscriber on policy B09M000830
Claims
3
Attributed to this person
Charged
1,194.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
249.60
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 | LEILA HUGHES |
| Role on the policy | Subscriber |
| Policy | B09M000830 |
| Date of birth | 23 Jan 2002 |
| Plan | PLATINUM PPO |
| Covered from | 24 Jul 2024 |
| Covered to | 7 Dec 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 249.60 |
| Total | 249.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003527 | 27 Dec 2024 | 523.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003528 | 24 Nov 2024 | 287.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003529 | 18 Aug 2024 | 384.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |