GRACE USMAN
Dependent on policy B03M000807
Claims
3
Attributed to this person
Charged
1,632.00
Total submitted
Denied
370.00
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 | GRACE USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000807 |
| Date of birth | 16 Nov 1951 |
| Plan | SILVER HMO |
| Covered from | 17 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 |
|---|---|---|---|---|---|
| CLM0003473 | 18 Oct 2025 | 578.00 | CASCADE CARE | Not denied | — |
| CLM0003472 | 16 Jan 2025 | 684.00 | CASCADE CARE | Not denied | — |
| CLM0003471 | 3 Nov 2024 | 370.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 370.00 |