RAVI USMAN
Dependent on policy B05M000186
Claims
1
Attributed to this person
Charged
233.00
Total submitted
Denied
233.00
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 | RAVI USMAN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000186 |
| Date of birth | 22 May 1969 |
| Plan | SILVER HMO |
| Covered from | 18 Apr 2024 |
| Covered to | 2 Jul 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000783 | 4 Apr 2024 | 233.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 233.00 |