YUSUF WILSON
Subscriber on policy B02M000641
Claims
2
Attributed to this person
Charged
825.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
110.25
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 WILSON |
| Role on the policy | Subscriber |
| Policy | B02M000641 |
| Date of birth | 7 Nov 1957 |
| Plan | SILVER HMO |
| Covered from | 25 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 110.25 |
| Total | 110.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002697 | 28 Sep 2025 | 90.00 | CASCADE CARE | Not denied | — |
| CLM0002696 | 23 Apr 2025 | 735.00 | CASCADE CARE | Not denied | — |