SOFIA USMAN
Dependent on policy B01M000494
Claims
3
Attributed to this person
Charged
1,321.00
Total submitted
Denied
222.01
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 | SOFIA USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000494 |
| Date of birth | 2 Sep 1964 |
| Plan | PLATINUM PPO |
| Covered from | 28 Jan 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002208 | 28 May 2026 | 479.00 | CASCADE CARE | Not denied | — |
| CLM0002206 | 11 Sep 2025 | 343.00 | CASCADE CARE | Not denied | — |
| CLM0002207 | 19 May 2024 | 499.00 | CASCADE CARE | CARC 11 · CODING | 222.01 |