YUSUF ANDERSON
Subscriber on policy B05M000757
Claims
1
Attributed to this person
Charged
240.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
25.00
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B05M000757 |
| Date of birth | 27 Jan 1980 |
| Plan | PLATINUM PPO |
| Covered from | 27 Feb 2025 |
| Covered to | 10 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003235 | 24 Mar 2025 | 240.00 | MERIDIAN HEALTH PLAN | Not denied | — |