TOMAS USMAN
Dependent on policy B08M000399
Claims
3
Attributed to this person
Charged
1,828.00
Total submitted
Denied
223.00
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 | TOMAS USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000399 |
| Date of birth | 22 Feb 1963 |
| Plan | SILVER HMO |
| Covered from | 6 Jan 2024 |
| Covered to | 27 Jul 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001830 | 21 Aug 2024 | 223.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 223.00 |
| CLM0001831 | 11 Jul 2024 | 858.00 | CASCADE CARE | Not denied | — |
| CLM0001829 | 10 Feb 2024 | 747.00 | CASCADE CARE | Not denied | — |