KEVIN USMAN
Dependent on policy B05M000349
Claims
2
Attributed to this person
Charged
1,162.00
Total submitted
Denied
765.00
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 | KEVIN USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000349 |
| Date of birth | 22 Jul 2008 |
| Plan | PLATINUM PPO |
| Covered from | 3 Aug 2024 |
| Covered to | 22 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001492 | 21 Mar 2025 | 397.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001491 | 1 Nov 2024 | 765.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 765.00 |