JULIA USMAN
Dependent on policy B10M000306
Claims
2
Attributed to this person
Charged
435.00
Total submitted
Denied
193.00
1 denied claims
Patient responsibility
48.40
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 | JULIA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000306 |
| Date of birth | 12 Oct 2018 |
| Plan | SILVER HMO |
| Covered from | 23 Dec 2024 |
| Covered to | 6 Oct 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 48.40 |
| Total | 48.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001286 | 17 Apr 2025 | 242.00 | CASCADE CARE | Not denied | — |
| CLM0001287 | 5 Dec 2024 | 193.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 193.00 |