UMA USMAN
Subscriber on policy B03M000595
Claims
2
Attributed to this person
Charged
431.00
Total submitted
Denied
158.59
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 | Subscriber |
| Policy | B03M000595 |
| Date of birth | 17 Feb 1975 |
| Plan | SILVER HMO |
| Covered from | 8 Sep 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 |
|---|---|---|---|---|---|
| CLM0002441 | 27 Apr 2026 | 350.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 158.59 |
| CLM0002440 | 20 Oct 2024 | 81.00 | NORTHSTAR MUTUAL | Not denied | — |