RAVI USMAN
Subscriber on policy B03M000006
Claims
3
Attributed to this person
Charged
1,109.00
Total submitted
Denied
160.00
1 denied claims
Patient responsibility
76.40
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 | RAVI USMAN |
| Role on the policy | Subscriber |
| Policy | B03M000006 |
| Date of birth | 15 Jun 1984 |
| Plan | SILVER HMO |
| Covered from | 19 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 76.40 |
| Total | 76.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000026 | 24 Apr 2026 | 382.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000027 | 29 Jul 2025 | 160.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 160.00 |
| CLM0000025 | 13 Oct 2024 | 567.00 | MERIDIAN HEALTH PLAN | Not denied | — |