OMAR HUGHES
Subscriber on policy B02M000712
Claims
2
Attributed to this person
Charged
676.00
Total submitted
Denied
67.74
1 denied claims
Patient responsibility
78.60
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 | OMAR HUGHES |
| Role on the policy | Subscriber |
| Policy | B02M000712 |
| Date of birth | 29 Aug 2002 |
| Plan | PLATINUM PPO |
| Covered from | 19 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 78.60 |
| Total | 78.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002995 | 23 Jan 2026 | 393.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002996 | 6 Oct 2025 | 283.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 67.74 |