ZARA USMAN
Dependent on policy B10M000273
Claims
2
Attributed to this person
Charged
727.00
Total submitted
Denied
224.00
1 denied claims
Patient responsibility
20.00
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 | ZARA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000273 |
| Date of birth | 17 Mar 1991 |
| Plan | SILVER HMO |
| Covered from | 26 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001140 | 8 Oct 2025 | 503.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001141 | 15 Aug 2025 | 224.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 224.00 |