MARCUS USMAN
Subscriber on policy B05M000581
Claims
2
Attributed to this person
Charged
1,244.00
Total submitted
Denied
677.00
1 denied claims
Patient responsibility
85.05
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 | MARCUS USMAN |
| Role on the policy | Subscriber |
| Policy | B05M000581 |
| Date of birth | 22 Jan 1988 |
| Plan | GOLD PPO |
| Covered from | 14 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 85.05 |
| Total | 85.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002470 | 23 Apr 2026 | 677.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 677.00 |
| CLM0002471 | 22 Oct 2025 | 567.00 | NORTHSTAR MUTUAL | Not denied | — |