RAVI USMAN
Subscriber on policy B05M000284
Claims
2
Attributed to this person
Charged
1,106.00
Total submitted
Denied
323.95
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 | RAVI USMAN |
| Role on the policy | Subscriber |
| Policy | B05M000284 |
| Date of birth | 22 Dec 1956 |
| Plan | GOLD PPO |
| Covered from | 3 Apr 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 |
|---|---|---|---|---|---|
| CLM0001170 | 31 Jul 2026 | 503.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 156.45 |
| CLM0001169 | 16 May 2024 | 603.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 167.50 |