KEVIN HUGHES
Dependent on policy B02M000403
Claims
3
Attributed to this person
Charged
1,980.00
Total submitted
Denied
1,182.00
2 denied claims
Patient responsibility
159.60
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 | KEVIN HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000403 |
| Date of birth | 26 Jun 2010 |
| Plan | BRONZE EPO |
| Covered from | 13 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 159.60 |
| Total | 159.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001735 | 19 Apr 2026 | 760.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 760.00 |
| CLM0001734 | 15 Feb 2026 | 422.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 422.00 |
| CLM0001733 | 14 Jul 2025 | 798.00 | NORTHSTAR MUTUAL | Not denied | — |