DAVID HUGHES
Subscriber on policy B02M000088
Claims
2
Attributed to this person
Charged
437.00
Total submitted
Denied
104.00
1 denied claims
Patient responsibility
15.00
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 | DAVID HUGHES |
| Role on the policy | Subscriber |
| Policy | B02M000088 |
| Date of birth | 3 Mar 1973 |
| Plan | GOLD PPO |
| Covered from | 6 Dec 2024 |
| Covered to | 8 Jun 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 15.00 |
| Total | 15.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000401 | 22 Jul 2025 | 104.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 104.00 |
| CLM0000402 | 25 Nov 2024 | 333.00 | MERIDIAN HEALTH PLAN | Not denied | — |