OMAR EVANS
Subscriber on policy B09M000815
Claims
2
Attributed to this person
Charged
1,311.00
Total submitted
Denied
868.00
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 EVANS |
| Role on the policy | Subscriber |
| Policy | B09M000815 |
| Date of birth | 10 Sep 1960 |
| Plan | PLATINUM PPO |
| Covered from | 1 Jan 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 |
|---|---|---|---|---|---|
| CLM0003459 | 9 Jun 2026 | 443.00 | CASCADE CARE | Not denied | — |
| CLM0003458 | 29 Dec 2023 | 868.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 868.00 |