TOMAS HUGHES
Dependent on policy B01M000807
Claims
3
Attributed to this person
Charged
686.00
Total submitted
Denied
72.00
1 denied claims
Patient responsibility
42.75
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 | TOMAS HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000807 |
| Date of birth | 12 May 2012 |
| Plan | SILVER HMO |
| Covered from | 15 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 42.75 |
| Total | 42.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003592 | 12 Jul 2026 | 329.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003593 | 14 Jan 2026 | 72.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 72.00 |
| CLM0003594 | 8 Aug 2024 | 285.00 | MERIDIAN HEALTH PLAN | Not denied | — |