FIONA USMAN
Dependent on policy B08M000128
Claims
2
Attributed to this person
Charged
159.00
Total submitted
Denied
92.00
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 | FIONA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000128 |
| Date of birth | 21 Jan 1983 |
| Plan | BRONZE EPO |
| Covered from | 19 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000581 | 22 Dec 2025 | 92.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 92.00 |
| CLM0000582 | 20 Jul 2025 | 67.00 | NORTHSTAR MUTUAL | Not denied | — |