OMAR ANDERSON
Subscriber on policy B06M000468
Claims
1
Attributed to this person
Charged
812.00
Total submitted
Denied
812.00
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 | OMAR ANDERSON |
| Role on the policy | Subscriber |
| Policy | B06M000468 |
| Date of birth | 23 Feb 1985 |
| Plan | PLATINUM PPO |
| Covered from | 22 Jan 2024 |
| Covered to | 22 Mar 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 |
|---|---|---|---|---|---|
| CLM0002113 | 13 Jan 2024 | 812.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 812.00 |