TOMAS USMAN
Dependent on policy B09M000898
Claims
1
Attributed to this person
Charged
373.00
Total submitted
Denied
373.00
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 | TOMAS USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000898 |
| Date of birth | 4 Oct 2017 |
| Plan | PLATINUM PPO |
| Covered from | 26 Apr 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003845 | 10 Apr 2025 | 373.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 373.00 |