LEILA HUGHES
Subscriber on policy B10M000891
Claims
3
Attributed to this person
Charged
1,185.00
Total submitted
Denied
0.00
0 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 | LEILA HUGHES |
| Role on the policy | Subscriber |
| Policy | B10M000891 |
| Date of birth | 5 Apr 1971 |
| Plan | GOLD PPO |
| Covered from | 15 Apr 2024 |
| Covered to | 14 Nov 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003792 | 5 Oct 2024 | 442.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003793 | 19 May 2024 | 82.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003794 | 9 May 2024 | 661.00 | NORTHSTAR MUTUAL | Not denied | — |