UMA USMAN
Dependent on policy B02M000642
Claims
2
Attributed to this person
Charged
711.00
Total submitted
Denied
369.00
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 | UMA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000642 |
| Date of birth | 26 Aug 2022 |
| Plan | SILVER HMO |
| Covered from | 21 Jun 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 |
|---|---|---|---|---|---|
| CLM0002709 | 1 Mar 2025 | 342.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002710 | 5 Nov 2024 | 369.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 369.00 |