IVAN HUGHES
Dependent on policy B05M000215
Claims
3
Attributed to this person
Charged
1,168.00
Total submitted
Denied
443.00
1 denied claims
Patient responsibility
25.50
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 | B05M000215 |
| Date of birth | 22 Dec 1947 |
| Plan | GOLD PPO |
| Covered from | 27 Aug 2024 |
| Covered to | 25 Apr 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 25.50 |
| Total | 25.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000889 | 22 Jun 2025 | 443.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 443.00 |
| CLM0000891 | 16 Apr 2025 | 170.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000890 | 17 Dec 2024 | 555.00 | MERIDIAN HEALTH PLAN | Not denied | — |