HENRY HUGHES
Subscriber on policy B03M000365
Claims
2
Attributed to this person
Charged
842.00
Total submitted
Denied
259.00
2 denied claims
Patient responsibility
378.95
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 | HENRY HUGHES |
| Role on the policy | Subscriber |
| Policy | B03M000365 |
| Date of birth | 25 Nov 1970 |
| Plan | SILVER HMO |
| Covered from | 10 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 378.95 |
| Total | 378.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001487 | 8 Mar 2026 | 259.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 259.00 |
| CLM0001486 | 10 Apr 2024 | 583.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |