OMAR HUGHES
Subscriber on policy B05M000643
Claims
3
Attributed to this person
Charged
1,679.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
101.85
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 | OMAR HUGHES |
| Role on the policy | Subscriber |
| Policy | B05M000643 |
| Date of birth | 13 Oct 1956 |
| Plan | BRONZE EPO |
| Covered from | 12 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 101.85 |
| Total | 101.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002771 | 18 Jul 2026 | 673.00 | CASCADE CARE | Not denied | — |
| CLM0002772 | 7 Feb 2026 | 679.00 | CASCADE CARE | Not denied | — |
| CLM0002770 | 2 Feb 2026 | 327.00 | CASCADE CARE | Not denied | — |