BRIAN USMAN
Subscriber on policy B05M000009
Claims
2
Attributed to this person
Charged
596.00
Total submitted
Denied
75.00
2 denied claims
Patient responsibility
338.65
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 | Subscriber |
| Policy | B05M000009 |
| Date of birth | 23 Oct 1983 |
| Plan | PLATINUM PPO |
| Covered from | 7 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 338.65 |
| Total | 338.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000032 | 18 Dec 2024 | 521.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000031 | 13 Jun 2024 | 75.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 75.00 |