FIONA USMAN
Dependent on policy B06M000254
Claims
1
Attributed to this person
Charged
679.00
Total submitted
Denied
679.00
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 | FIONA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000254 |
| Date of birth | 21 Jan 1992 |
| Plan | BRONZE EPO |
| Covered from | 17 May 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 |
|---|---|---|---|---|---|
| CLM0001209 | 12 Mar 2026 | 679.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 679.00 |