OMAR WILSON
Dependent on policy B04M000006
Claims
2
Attributed to this person
Charged
398.00
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 WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000006 |
| Date of birth | 9 Sep 2002 |
| Plan | PLATINUM PPO |
| Covered from | 8 Oct 2024 |
| Covered to | 4 Jan 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 |
|---|---|---|---|---|---|
| CLM0000028 | 10 Nov 2024 | 279.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000027 | 29 Oct 2024 | 119.00 | MERIDIAN HEALTH PLAN | Not denied | — |