TOMAS USMAN
Dependent on policy B05M000601
Claims
3
Attributed to this person
Charged
1,565.00
Total submitted
Denied
606.92
2 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 | TOMAS USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000601 |
| Date of birth | 21 Jan 1998 |
| Plan | SILVER HMO |
| Covered from | 14 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002577 | 30 Nov 2025 | 701.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002578 | 22 Nov 2025 | 264.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 6.92 |
| CLM0002579 | 4 Jul 2025 | 600.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 600.00 |