YUSUF ANDERSON
Dependent on policy B04M000198
Claims
3
Attributed to this person
Charged
1,892.00
Total submitted
Denied
1,261.00
3 denied claims
Patient responsibility
410.15
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 ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000198 |
| Date of birth | 6 Nov 1969 |
| Plan | GOLD PPO |
| Covered from | 30 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 410.15 |
| Total | 410.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000882 | 3 Sep 2025 | 455.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 455.00 |
| CLM0000884 | 23 Jan 2025 | 806.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 806.00 |
| CLM0000883 | 18 Dec 2024 | 631.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |