YUSUF EVANS
Subscriber on policy B07M000881
Claims
3
Attributed to this person
Charged
1,276.00
Total submitted
Denied
1,276.00
3 denied claims
Patient responsibility
0.00
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 EVANS |
| Role on the policy | Subscriber |
| Policy | B07M000881 |
| Date of birth | 13 Sep 1974 |
| Plan | PLATINUM PPO |
| Covered from | 12 Sep 2024 |
| Covered to | 29 Dec 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003645 | 19 Feb 2025 | 606.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 606.00 |
| CLM0003646 | 20 Dec 2024 | 454.00 | CASCADE CARE | CARC 18 · DUPLICATE | 454.00 |
| CLM0003647 | 7 Sep 2024 | 216.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 216.00 |