LEILA USMAN
Subscriber on policy B07M000602
Claims
2
Attributed to this person
Charged
1,418.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
128.10
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 | LEILA USMAN |
| Role on the policy | Subscriber |
| Policy | B07M000602 |
| Date of birth | 28 May 1955 |
| Plan | BRONZE EPO |
| Covered from | 20 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 128.10 |
| Total | 128.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002536 | 22 Nov 2025 | 854.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002537 | 1 Apr 2025 | 564.00 | MERIDIAN HEALTH PLAN | Not denied | — |