CARLA USMAN
Dependent on policy B07M000376
Claims
2
Attributed to this person
Charged
1,014.00
Total submitted
Denied
570.00
1 denied claims
Patient responsibility
66.60
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 | CARLA USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000376 |
| Date of birth | 17 Apr 1965 |
| Plan | BRONZE EPO |
| Covered from | 6 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 66.60 |
| Total | 66.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001603 | 11 Aug 2026 | 570.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 570.00 |
| CLM0001602 | 1 Jan 2026 | 444.00 | MERIDIAN HEALTH PLAN | Not denied | — |