OMAR WILSON
Subscriber on policy B10M000260
Claims
1
Attributed to this person
Charged
783.00
Total submitted
Denied
783.00
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 WILSON |
| Role on the policy | Subscriber |
| Policy | B10M000260 |
| Date of birth | 23 Nov 1962 |
| Plan | BRONZE EPO |
| Covered from | 9 Jul 2024 |
| Covered to | 26 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001066 | 9 Apr 2025 | 783.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 783.00 |