MARCUS HUGHES
Subscriber on policy B01M000207
Claims
3
Attributed to this person
Charged
1,948.00
Total submitted
Denied
792.00
1 denied claims
Patient responsibility
115.05
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 | MARCUS HUGHES |
| Role on the policy | Subscriber |
| Policy | B01M000207 |
| Date of birth | 1 Feb 1951 |
| Plan | BRONZE EPO |
| Covered from | 13 May 2024 |
| Covered to | 12 Sep 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 115.05 |
| Total | 115.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000872 | 15 Sep 2024 | 389.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000874 | 23 Jul 2024 | 767.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000873 | 10 May 2024 | 792.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 792.00 |