RAVI HUGHES
Subscriber on policy B04M000734
Claims
3
Attributed to this person
Charged
898.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
20.00
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 | RAVI HUGHES |
| Role on the policy | Subscriber |
| Policy | B04M000734 |
| Date of birth | 30 Aug 1979 |
| Plan | PLATINUM PPO |
| Covered from | 2 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003211 | 24 May 2026 | 544.00 | CASCADE CARE | Not denied | — |
| CLM0003210 | 6 Apr 2026 | 235.00 | CASCADE CARE | Not denied | — |
| CLM0003209 | 11 Mar 2024 | 119.00 | CASCADE CARE | Not denied | — |