OMAR PATEL
Dependent on policy B03M000183
Claims
3
Attributed to this person
Charged
1,768.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
58.80
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 PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000183 |
| Date of birth | 27 Jul 1997 |
| Plan | PLATINUM PPO |
| Covered from | 3 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 58.80 |
| Total | 58.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000750 | 23 Mar 2026 | 392.00 | CASCADE CARE | Not denied | — |
| CLM0000751 | 29 Jan 2026 | 879.00 | CASCADE CARE | Not denied | — |
| CLM0000749 | 20 Jul 2024 | 497.00 | CASCADE CARE | Not denied | — |