OMAR USMAN
Subscriber on policy B01M000022
Claims
2
Attributed to this person
Charged
1,522.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
115.50
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 | B01M000022 |
| Date of birth | 22 Aug 2001 |
| Plan | SILVER HMO |
| Covered from | 9 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 100.50 |
| CARC 3 · Copay | 1 | 15.00 |
| Total | 115.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000082 | 14 Mar 2026 | 670.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000081 | 10 Jan 2026 | 852.00 | MERIDIAN HEALTH PLAN | Not denied | — |