ZARA USMAN
Subscriber on policy B09M000874
Claims
3
Attributed to this person
Charged
1,256.00
Total submitted
Denied
126.63
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 | ZARA USMAN |
| Role on the policy | Subscriber |
| Policy | B09M000874 |
| Date of birth | 18 Jun 1975 |
| Plan | SILVER HMO |
| Covered from | 17 Sep 2024 |
| Covered to | 15 May 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 |
|---|---|---|---|---|---|
| CLM0003707 | 30 Apr 2025 | 619.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 126.63 |
| CLM0003706 | 22 Jan 2025 | 284.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003708 | 16 Oct 2024 | 353.00 | NORTHSTAR MUTUAL | Not denied | — |