VICTOR USMAN
Dependent on policy B03M000451
Claims
1
Attributed to this person
Charged
237.00
Total submitted
Denied
237.00
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 | VICTOR USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000451 |
| Date of birth | 16 Jul 2009 |
| Plan | GOLD PPO |
| Covered from | 14 Nov 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 |
|---|---|---|---|---|---|
| CLM0001864 | 22 Apr 2026 | 237.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 237.00 |