OMAR USMAN
Subscriber on policy B10M000263
Claims
3
Attributed to this person
Charged
1,697.00
Total submitted
Denied
586.00
1 denied claims
Patient responsibility
40.00
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 | OMAR USMAN |
| Role on the policy | Subscriber |
| Policy | B10M000263 |
| Date of birth | 10 Feb 1990 |
| Plan | GOLD PPO |
| Covered from | 6 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001081 | 7 Aug 2025 | 586.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 586.00 |
| CLM0001082 | 3 Aug 2025 | 744.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001080 | 6 May 2025 | 367.00 | MERIDIAN HEALTH PLAN | Not denied | — |