KEVIN USMAN
Dependent on policy B08M000128
Claims
3
Attributed to this person
Charged
1,481.00
Total submitted
Denied
592.00
2 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 | KEVIN USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000128 |
| Date of birth | 22 Jul 1975 |
| 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 |
|---|---|---|---|---|---|
| CLM0000583 | 14 Dec 2025 | 889.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000585 | 11 Jun 2025 | 205.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 205.00 |
| CLM0000584 | 28 Apr 2025 | 387.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 387.00 |