WENDY USMAN
Subscriber on policy B06M000132
Claims
2
Attributed to this person
Charged
489.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
135.85
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 | WENDY USMAN |
| Role on the policy | Subscriber |
| Policy | B06M000132 |
| Date of birth | 11 Jul 1968 |
| Plan | GOLD PPO |
| Covered from | 13 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 135.85 |
| Total | 135.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000650 | 22 Jul 2026 | 280.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000649 | 3 Sep 2025 | 209.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |