CARLA USMAN
Subscriber on policy B03M000301
Claims
2
Attributed to this person
Charged
1,243.00
Total submitted
Denied
212.16
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 | CARLA USMAN |
| Role on the policy | Subscriber |
| Policy | B03M000301 |
| Date of birth | 16 Nov 1978 |
| Plan | SILVER HMO |
| Covered from | 24 Oct 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 |
|---|---|---|---|---|---|
| CLM0001199 | 21 Jan 2026 | 589.00 | CASCADE CARE | Not denied | — |
| CLM0001198 | 13 Dec 2024 | 654.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 212.16 |