YUSUF FOSTER
Dependent on policy B05M000610
Claims
2
Attributed to this person
Charged
935.00
Total submitted
Denied
334.00
1 denied claims
Patient responsibility
120.20
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 FOSTER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000610 |
| Date of birth | 15 Oct 2003 |
| Plan | PLATINUM PPO |
| Covered from | 15 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 120.20 |
| Total | 120.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002613 | 30 Jan 2026 | 334.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 334.00 |
| CLM0002612 | 4 Sep 2024 | 601.00 | MERIDIAN HEALTH PLAN | Not denied | — |