VICTOR BAKER
Subscriber on policy B06M000013
Claims
3
Attributed to this person
Charged
974.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
12.75
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 | VICTOR BAKER |
| Role on the policy | Subscriber |
| Policy | B06M000013 |
| Date of birth | 19 Oct 1996 |
| Plan | PLATINUM PPO |
| Covered from | 7 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 12.75 |
| Total | 12.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000072 | 8 Jun 2025 | 370.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000070 | 8 May 2025 | 85.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000071 | 3 Aug 2024 | 519.00 | NORTHSTAR MUTUAL | Not denied | — |