LEILA HUGHES
Dependent on policy B02M000173
Claims
2
Attributed to this person
Charged
714.00
Total submitted
Denied
37.08
1 denied claims
Patient responsibility
30.00
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 | Dependent · relationship 01 |
| Policy | B02M000173 |
| Date of birth | 17 Jul 1992 |
| Plan | SILVER HMO |
| Covered from | 27 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000779 | 18 May 2026 | 540.00 | CASCADE CARE | Not denied | — |
| CLM0000780 | 9 May 2026 | 174.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 37.08 |