YUSUF JOHNSON
Dependent on policy B04M000167
Claims
3
Attributed to this person
Charged
1,927.00
Total submitted
Denied
585.00
2 denied claims
Patient responsibility
534.30
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 JOHNSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000167 |
| Date of birth | 6 May 1987 |
| Plan | BRONZE EPO |
| Covered from | 14 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 534.30 |
| Total | 534.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000765 | 14 Jul 2026 | 520.00 | CASCADE CARE | Not denied | — |
| CLM0000764 | 11 Aug 2025 | 585.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 585.00 |
| CLM0000763 | 28 Mar 2025 | 822.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |