JULIA USMAN
Dependent on policy B08M000857
Claims
2
Attributed to this person
Charged
554.00
Total submitted
Denied
115.00
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 | JULIA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000857 |
| Date of birth | 9 May 2017 |
| Plan | BRONZE EPO |
| Covered from | 13 Oct 2024 |
| Covered to | 17 Jan 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003840 | 12 Oct 2024 | 439.00 | CASCADE CARE | Not denied | — |
| CLM0003839 | 1 Oct 2024 | 115.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 115.00 |