AMARA USMAN
Dependent on policy B07M000477
Claims
2
Attributed to this person
Charged
1,493.00
Total submitted
Denied
878.00
1 denied claims
Patient responsibility
50.00
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 | AMARA USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000477 |
| Date of birth | 2 Jan 2002 |
| Plan | GOLD PPO |
| Covered from | 3 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002034 | 20 Oct 2025 | 615.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002035 | 5 Jul 2024 | 878.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 878.00 |