ZARA USMAN
Dependent on policy B09M000031
Claims
1
Attributed to this person
Charged
129.00
Total submitted
Denied
54.35
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 | Dependent · relationship 01 |
| Policy | B09M000031 |
| Date of birth | 21 Oct 1970 |
| Plan | SILVER HMO |
| Covered from | 17 Jun 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000141 | 20 Nov 2025 | 129.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 54.35 |