ELENA USMAN
Dependent on policy B02M000505
Claims
3
Attributed to this person
Charged
1,950.00
Total submitted
Denied
108.92
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 | ELENA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000505 |
| Date of birth | 15 Sep 2013 |
| Plan | BRONZE EPO |
| Covered from | 31 May 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 |
|---|---|---|---|---|---|
| CLM0002149 | 19 May 2026 | 478.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 108.92 |
| CLM0002148 | 5 Feb 2026 | 808.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002150 | 30 Aug 2025 | 664.00 | MERIDIAN HEALTH PLAN | Not denied | — |