MARCUS HUGHES
Dependent on policy B09M000055
Claims
1
Attributed to this person
Charged
766.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
497.90
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 | MARCUS HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000055 |
| Date of birth | 26 May 2011 |
| Plan | PLATINUM PPO |
| Covered from | 8 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 497.90 |
| Total | 497.90 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000256 | 25 Jan 2026 | 766.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |