GRACE USMAN
Dependent on policy B02M000261
Claims
3
Attributed to this person
Charged
1,656.00
Total submitted
Denied
886.00
2 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 | GRACE USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000261 |
| Date of birth | 16 Nov 1984 |
| Plan | PLATINUM PPO |
| Covered from | 16 Aug 2024 |
| Covered to | 12 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001149 | 8 May 2025 | 92.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 92.00 |
| CLM0001148 | 14 Apr 2025 | 794.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 794.00 |
| CLM0001147 | 28 Sep 2024 | 770.00 | CASCADE CARE | Not denied | — |