PRIYA USMAN
Dependent on policy B06M000284
Claims
2
Attributed to this person
Charged
686.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
111.75
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 | PRIYA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000284 |
| Date of birth | 4 Aug 1980 |
| Plan | GOLD PPO |
| Covered from | 14 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 76.35 |
| CARC 2 · Coinsurance | 1 | 35.40 |
| Total | 111.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001325 | 1 Jun 2025 | 509.00 | CASCADE CARE | Not denied | — |
| CLM0001324 | 20 Mar 2024 | 177.00 | CASCADE CARE | Not denied | — |