UMA HUGHES
Subscriber on policy B04M000239
Claims
2
Attributed to this person
Charged
269.00
Total submitted
Denied
269.00
2 denied claims
Patient responsibility
0.00
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 | UMA HUGHES |
| Role on the policy | Subscriber |
| Policy | B04M000239 |
| Date of birth | 26 Nov 1993 |
| Plan | BRONZE EPO |
| Covered from | 20 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001039 | 15 Aug 2025 | 165.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 165.00 |
| CLM0001040 | 22 Jan 2024 | 104.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 104.00 |