OMAR WILSON
Dependent on policy B08M000249
Claims
2
Attributed to this person
Charged
961.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
79.80
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 | OMAR WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000249 |
| Date of birth | 7 Apr 1993 |
| Plan | PLATINUM PPO |
| Covered from | 7 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 79.80 |
| Total | 79.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001129 | 4 Mar 2026 | 399.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001130 | 19 Sep 2025 | 562.00 | MERIDIAN HEALTH PLAN | Not denied | — |