YUSUF EVANS
Subscriber on policy B08M000043
Claims
1
Attributed to this person
Charged
758.00
Total submitted
Denied
758.00
1 denied claims
Patient responsibility
0.00
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient โ 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 | B08M000043 |
| Date of birth | 1 Jan 1977 |
| Plan | BRONZE EPO |
| Covered from | 22 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000178 | 22 Aug 2025 | 758.00 | MERIDIAN HEALTH PLAN | CARC 29 ยท TIMELY_FILING | 758.00 |