YUSUF PATEL
Subscriber on policy B07M000183
Claims
3
Attributed to this person
Charged
1,978.00
Total submitted
Denied
549.38
2 denied claims
Patient responsibility
172.00
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 | YUSUF PATEL |
| Role on the policy | Subscriber |
| Policy | B07M000183 |
| Date of birth | 27 Oct 2002 |
| Plan | BRONZE EPO |
| Covered from | 10 Apr 2025 |
| Covered to | 13 Oct 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 172.00 |
| Total | 172.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000754 | 27 Oct 2025 | 309.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 309.00 |
| CLM0000756 | 17 Sep 2025 | 860.00 | CASCADE CARE | Not denied | — |
| CLM0000755 | 15 Sep 2025 | 809.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 240.38 |