TOMAS BAKER
Dependent on policy B01M000563
Claims
3
Attributed to this person
Charged
2,010.00
Total submitted
Denied
561.00
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 | TOMAS BAKER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000563 |
| Date of birth | 1 Jan 1995 |
| Plan | PLATINUM PPO |
| Covered from | 22 May 2025 |
| Covered to | 13 Feb 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002510 | 31 Oct 2025 | 730.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002509 | 6 Sep 2025 | 561.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 561.00 |
| CLM0002508 | 14 Aug 2025 | 719.00 | NORTHSTAR MUTUAL | Not denied | — |