BRIAN HUGHES
Subscriber on policy B04M000137
Claims
2
Attributed to this person
Charged
585.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
102.40
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 | BRIAN HUGHES |
| Role on the policy | Subscriber |
| Policy | B04M000137 |
| Date of birth | 15 Apr 1959 |
| Plan | SILVER HMO |
| Covered from | 17 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 102.40 |
| Total | 102.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000631 | 26 May 2025 | 73.00 | CASCADE CARE | Not denied | — |
| CLM0000632 | 15 Apr 2025 | 512.00 | CASCADE CARE | Not denied | — |