IVAN USMAN
Subscriber on policy B09M000634
Claims
3
Attributed to this person
Charged
1,954.00
Total submitted
Denied
898.00
1 denied claims
Patient responsibility
62.60
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 | IVAN USMAN |
| Role on the policy | Subscriber |
| Policy | B09M000634 |
| Date of birth | 8 Dec 1965 |
| Plan | BRONZE EPO |
| Covered from | 7 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 62.60 |
| Total | 62.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002692 | 6 Aug 2026 | 743.00 | CASCADE CARE | Not denied | — |
| CLM0002690 | 23 Jan 2025 | 313.00 | CASCADE CARE | Not denied | — |
| CLM0002691 | 17 Jan 2025 | 898.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 898.00 |