RAVI USMAN
Dependent on policy B06M000725
Claims
3
Attributed to this person
Charged
994.00
Total submitted
Denied
285.00
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 | RAVI USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000725 |
| Date of birth | 3 Dec 2004 |
| Plan | SILVER HMO |
| Covered from | 18 Apr 2024 |
| Covered to | 30 Aug 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003242 | 13 Oct 2024 | 285.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 285.00 |
| CLM0003240 | 15 Jul 2024 | 465.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003241 | 24 Mar 2024 | 244.00 | NORTHSTAR MUTUAL | Not denied | — |