IVAN HUGHES
Dependent on policy B04M000634
Claims
1
Attributed to this person
Charged
633.00
Total submitted
Denied
633.00
1 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 | IVAN HUGHES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000634 |
| Date of birth | 9 Aug 1990 |
| Plan | PLATINUM PPO |
| Covered from | 1 Mar 2024 |
| Covered to | 30 Jun 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002756 | 2 Jul 2024 | 633.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 633.00 |