CARLA USMAN
Subscriber on policy B09M000336
Claims
3
Attributed to this person
Charged
1,753.00
Total submitted
Denied
787.00
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 | CARLA USMAN |
| Role on the policy | Subscriber |
| Policy | B09M000336 |
| Date of birth | 1 Nov 1970 |
| Plan | PLATINUM PPO |
| Covered from | 13 Feb 2025 |
| Covered to | 16 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001385 | 10 May 2025 | 787.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 787.00 |
| CLM0001387 | 25 Mar 2025 | 311.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001386 | 2 Mar 2025 | 655.00 | MERIDIAN HEALTH PLAN | Not denied | — |