OMAR ANDERSON
Dependent on policy B09M000617
Claims
1
Attributed to this person
Charged
524.00
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 ANDERSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000617 |
| Date of birth | 7 May 2006 |
| Plan | PLATINUM PPO |
| Covered from | 3 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002607 | 15 May 2025 | 524.00 | NORTHSTAR MUTUAL | Not denied | — |