OMAR EVANS
Subscriber on policy B08M000229
Claims
1
Attributed to this person
Charged
504.00
Total submitted
Denied
0.00
0 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 EVANS |
| Role on the policy | Subscriber |
| Policy | B08M000229 |
| Date of birth | 15 Jan 1958 |
| Plan | PLATINUM PPO |
| Covered from | 13 Feb 2024 |
| Covered to | 4 Sep 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 |
|---|---|---|---|---|---|
| CLM0001031 | 26 Feb 2024 | 504.00 | CASCADE CARE | Not denied | — |