DAVID USMAN
Dependent on policy B10M000406
Claims
1
Attributed to this person
Charged
255.00
Total submitted
Denied
255.00
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 | DAVID USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000406 |
| Date of birth | 7 Apr 2010 |
| Plan | GOLD PPO |
| Covered from | 3 Mar 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0001688 | 12 Feb 2026 | 255.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 255.00 |