DAVID USMAN
Subscriber on policy B01M000454
Claims
1
Attributed to this person
Charged
211.00
Total submitted
Denied
211.00
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 | DAVID USMAN |
| Role on the policy | Subscriber |
| Policy | B01M000454 |
| Date of birth | 23 Feb 1992 |
| Plan | PLATINUM PPO |
| Covered from | 20 Jun 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002033 | 14 Jun 2024 | 211.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 211.00 |