AMARA USMAN
Subscriber on policy B01M000281
Claims
2
Attributed to this person
Charged
720.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
106.60
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 | AMARA USMAN |
| Role on the policy | Subscriber |
| Policy | B01M000281 |
| Date of birth | 3 Jul 1953 |
| Plan | GOLD PPO |
| Covered from | 11 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 106.60 |
| Total | 106.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001216 | 24 Jan 2026 | 164.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0001217 | 25 Apr 2025 | 556.00 | CASCADE CARE | Not denied | — |