JULIA USMAN
Dependent on policy B03M000326
Claims
2
Attributed to this person
Charged
1,164.00
Total submitted
Denied
419.63
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 | JULIA USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000326 |
| Date of birth | 17 Jun 1988 |
| Plan | GOLD PPO |
| Covered from | 8 May 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 |
|---|---|---|---|---|---|
| CLM0001297 | 5 Apr 2026 | 363.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 170.68 |
| CLM0001296 | 17 Feb 2026 | 801.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 248.95 |