PRIYA USMAN
Dependent on policy B06M000475
Claims
3
Attributed to this person
Charged
1,896.00
Total submitted
Denied
1,142.00
2 denied claims
Patient responsibility
150.80
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 | PRIYA USMAN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000475 |
| Date of birth | 8 May 1999 |
| Plan | GOLD PPO |
| Covered from | 9 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 150.80 |
| Total | 150.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002148 | 4 May 2026 | 521.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 521.00 |
| CLM0002149 | 23 Mar 2026 | 621.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 621.00 |
| CLM0002150 | 22 Jan 2025 | 754.00 | MERIDIAN HEALTH PLAN | Not denied | — |