SOFIA USMAN
Subscriber on policy B07M000644
Claims
2
Attributed to this person
Charged
702.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
63.00
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 | SOFIA USMAN |
| Role on the policy | Subscriber |
| Policy | B07M000644 |
| Date of birth | 13 Nov 1981 |
| Plan | BRONZE EPO |
| Covered from | 27 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 63.00 |
| Total | 63.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002688 | 20 Oct 2025 | 420.00 | CASCADE CARE | Not denied | — |
| CLM0002689 | 17 Mar 2025 | 282.00 | CASCADE CARE | Not denied | — |