PRIYA USMAN
Subscriber on policy B09M000605
Claims
3
Attributed to this person
Charged
817.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
129.25
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 | PRIYA USMAN |
| Role on the policy | Subscriber |
| Policy | B09M000605 |
| Date of birth | 14 Feb 1977 |
| Plan | SILVER HMO |
| Covered from | 23 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 77.35 |
| CARC 1 · Deductible | 1 | 51.90 |
| Total | 129.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002553 | 7 Dec 2025 | 352.00 | CASCADE CARE | Not denied | — |
| CLM0002551 | 2 Nov 2025 | 346.00 | CASCADE CARE | Not denied | — |
| CLM0002552 | 14 Feb 2025 | 119.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |