WENDY USMAN
Subscriber on policy B06M000042
Claims
3
Attributed to this person
Charged
885.00
Total submitted
Denied
84.00
1 denied claims
Patient responsibility
66.15
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 | WENDY USMAN |
| Role on the policy | Subscriber |
| Policy | B06M000042 |
| Date of birth | 16 Jul 1957 |
| Plan | GOLD PPO |
| Covered from | 28 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 66.15 |
| Total | 66.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000235 | 22 Jul 2025 | 84.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 84.00 |
| CLM0000237 | 10 Jul 2025 | 360.00 | CASCADE CARE | Not denied | — |
| CLM0000236 | 9 May 2025 | 441.00 | CASCADE CARE | Not denied | — |