UMA USMAN
Subscriber on policy B09M000661
Claims
1
Attributed to this person
Charged
736.00
Total submitted
Denied
736.00
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 | UMA USMAN |
| Role on the policy | Subscriber |
| Policy | B09M000661 |
| Date of birth | 24 Jun 1983 |
| Plan | PLATINUM PPO |
| Covered from | 22 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002804 | 14 Apr 2024 | 736.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 736.00 |