JULIA USMAN
Subscriber on policy B05M000880
Claims
1
Attributed to this person
Charged
306.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
61.20
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 | JULIA USMAN |
| Role on the policy | Subscriber |
| Policy | B05M000880 |
| Date of birth | 2 Mar 1984 |
| Plan | SILVER HMO |
| Covered from | 16 Apr 2025 |
| Covered to | 1 Jan 2026 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 61.20 |
| Total | 61.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003733 | 31 Aug 2025 | 306.00 | NORTHSTAR MUTUAL | Not denied | — |