OMAR ANDERSON
Dependent on policy B06M000516
Claims
3
Attributed to this person
Charged
1,506.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
466.05
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 | Dependent · relationship 19 |
| Policy | B06M000516 |
| Date of birth | 22 Aug 2006 |
| Plan | BRONZE EPO |
| Covered from | 11 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 466.05 |
| Total | 466.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002301 | 13 Feb 2026 | 701.00 | CASCADE CARE | Not denied | — |
| CLM0002299 | 20 Feb 2025 | 88.00 | CASCADE CARE | Not denied | — |
| CLM0002300 | 23 Apr 2024 | 717.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |