AMARA USMAN
Dependent on policy B03M000027
Claims
2
Attributed to this person
Charged
644.00
Total submitted
Denied
340.00
1 denied claims
Patient responsibility
60.80
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 | AMARA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000027 |
| Date of birth | 15 Dec 2005 |
| Plan | SILVER HMO |
| Covered from | 25 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 60.80 |
| Total | 60.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000131 | 3 Oct 2025 | 340.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 340.00 |
| CLM0000130 | 15 Jul 2025 | 304.00 | MERIDIAN HEALTH PLAN | Not denied | — |