FIONA USMAN
Subscriber on policy B06M000888
Claims
3
Attributed to this person
Charged
1,387.00
Total submitted
Denied
21.18
1 denied claims
Patient responsibility
110.40
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 | FIONA USMAN |
| Role on the policy | Subscriber |
| Policy | B06M000888 |
| Date of birth | 18 Feb 1996 |
| Plan | GOLD PPO |
| Covered from | 24 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 110.40 |
| Total | 110.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003864 | 17 Jul 2025 | 736.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003862 | 11 Jul 2025 | 421.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003863 | 1 May 2024 | 230.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 21.18 |