YUSUF HUGHES
Dependent on policy B01M000476
Claims
1
Attributed to this person
Charged
661.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
429.65
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 | YUSUF HUGHES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000476 |
| Date of birth | 15 Apr 2004 |
| Plan | PLATINUM PPO |
| Covered from | 18 Mar 2025 |
| Covered to | 6 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 429.65 |
| Total | 429.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002117 | 26 Feb 2025 | 661.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |