BRIAN USMAN
Dependent on policy B01M000885
Claims
3
Attributed to this person
Charged
1,195.00
Total submitted
Denied
430.00
1 denied claims
Patient responsibility
50.00
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 | BRIAN USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000885 |
| Date of birth | 2 Dec 1978 |
| Plan | SILVER HMO |
| Covered from | 8 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003929 | 14 Feb 2026 | 430.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 430.00 |
| CLM0003928 | 17 Dec 2024 | 331.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003927 | 1 Mar 2024 | 434.00 | MERIDIAN HEALTH PLAN | Not denied | — |