CARLA USMAN
Dependent on policy B02M000826
Claims
2
Attributed to this person
Charged
1,292.00
Total submitted
Denied
1,292.00
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 | CARLA USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000826 |
| Date of birth | 26 Jul 1959 |
| Plan | SILVER HMO |
| Covered from | 9 Nov 2024 |
| Covered to | 18 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003440 | 25 Mar 2025 | 430.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 430.00 |
| CLM0003439 | 4 Nov 2024 | 862.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 862.00 |