OMAR WILSON
Subscriber on policy B05M000434
Claims
3
Attributed to this person
Charged
1,473.00
Total submitted
Denied
844.00
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 | B05M000434 |
| Date of birth | 30 Nov 1985 |
| Plan | PLATINUM PPO |
| Covered from | 5 Jul 2024 |
| Covered to | 7 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 |
|---|---|---|---|---|---|
| CLM0001830 | 19 Mar 2025 | 844.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 844.00 |
| CLM0001828 | 1 Jan 2025 | 565.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001829 | 11 Sep 2024 | 64.00 | MERIDIAN HEALTH PLAN | Not denied | — |