JULIA BAKER
Dependent on policy B06M000153
Claims
2
Attributed to this person
Charged
515.00
Total submitted
Denied
341.00
1 denied claims
Patient responsibility
26.10
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 | JULIA BAKER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000153 |
| Date of birth | 14 Jun 2017 |
| Plan | PLATINUM PPO |
| Covered from | 25 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 26.10 |
| Total | 26.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000761 | 10 Apr 2025 | 341.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 341.00 |
| CLM0000760 | 18 Jul 2024 | 174.00 | NORTHSTAR MUTUAL | Not denied | — |