YUSUF WILSON
Subscriber on policy B01M000728
Claims
1
Attributed to this person
Charged
121.00
Total submitted
Denied
25.56
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 — 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 | B01M000728 |
| Date of birth | 26 Sep 1957 |
| Plan | BRONZE EPO |
| Covered from | 15 Oct 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 |
|---|---|---|---|---|---|
| CLM0003235 | 10 Jan 2026 | 121.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 25.56 |