DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B06M000482›TOMAS USMAN

TOMAS USMAN

Dependent on policy B06M000482

Claims
2
Attributed to this person
Charged
851.00
Total submitted
Denied
775.00
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

FieldValue
NameTOMAS USMAN
Role on the policyDependent · relationship 19
PolicyB06M000482
Date of birth28 Feb 2016
PlanPLATINUM PPO
Covered from17 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000217821 Mar 2026775.00CASCADE CARECARC 18 · DUPLICATE775.00
CLM000217920 Dec 202476.00CASCADE CARENot denied—