GRACE USMAN
Subscriber on policy B05M000157
Claims
2
Attributed to this person
Charged
1,078.00
Total submitted
Denied
497.00
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 | GRACE USMAN |
| Role on the policy | Subscriber |
| Policy | B05M000157 |
| Date of birth | 5 Feb 1975 |
| Plan | BRONZE EPO |
| Covered from | 21 Jun 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 |
|---|---|---|---|---|---|
| CLM0000655 | 3 Jan 2026 | 497.00 | CASCADE CARE | CARC 18 · DUPLICATE | 497.00 |
| CLM0000654 | 22 Dec 2024 | 581.00 | CASCADE CARE | Not denied | — |