KEVIN USMAN
Dependent on policy B02M000307
Claims
2
Attributed to this person
Charged
392.00
Total submitted
Denied
242.87
2 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 | KEVIN USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000307 |
| Date of birth | 31 Dec 1968 |
| Plan | BRONZE EPO |
| Covered from | 21 Jun 2024 |
| Covered to | 4 Nov 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001323 | 22 Nov 2024 | 157.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 157.00 |
| CLM0001322 | 3 Jul 2024 | 235.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 85.87 |