OMAR WILSON
Subscriber on policy B02M000059
Claims
3
Attributed to this person
Charged
879.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
33.00
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 | B02M000059 |
| Date of birth | 18 Apr 1983 |
| Plan | SILVER HMO |
| Covered from | 1 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 33.00 |
| Total | 33.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000277 | 15 Jul 2026 | 160.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000278 | 23 Feb 2026 | 165.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000279 | 7 Jan 2025 | 554.00 | MERIDIAN HEALTH PLAN | Not denied | — |