OMAR USMAN
Dependent on policy B09M000634
Claims
3
Attributed to this person
Charged
1,304.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.00
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 | OMAR USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000634 |
| Date of birth | 16 Dec 2009 |
| Plan | BRONZE EPO |
| Covered from | 7 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002695 | 31 Jul 2026 | 602.00 | CASCADE CARE | Not denied | — |
| CLM0002694 | 18 Aug 2025 | 147.00 | CASCADE CARE | Not denied | — |
| CLM0002696 | 21 Jul 2025 | 555.00 | CASCADE CARE | Not denied | — |