OMAR ANDERSON
Subscriber on policy B04M000749
Claims
2
Attributed to this person
Charged
807.00
Total submitted
Denied
77.79
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B04M000749 |
| Date of birth | 19 Sep 1970 |
| Plan | SILVER HMO |
| Covered from | 14 Sep 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 |
|---|---|---|---|---|---|
| CLM0003268 | 3 Sep 2025 | 629.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003269 | 25 Apr 2025 | 178.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 77.79 |