ZARA USMAN
Subscriber on policy B05M000639
Claims
2
Attributed to this person
Charged
785.00
Total submitted
Denied
526.00
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 | ZARA USMAN |
| Role on the policy | Subscriber |
| Policy | B05M000639 |
| Date of birth | 8 Oct 1962 |
| Plan | BRONZE EPO |
| Covered from | 15 May 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 |
|---|---|---|---|---|---|
| CLM0002759 | 15 Nov 2024 | 259.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002757 | 29 Jun 2024 | 526.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 526.00 |