NADIA BAKER
Subscriber on policy B06M000322
Claims
3
Attributed to this person
Charged
1,408.00
Total submitted
Denied
1,292.00
3 denied claims
Patient responsibility
75.40
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 | NADIA BAKER |
| Role on the policy | Subscriber |
| Policy | B06M000322 |
| Date of birth | 14 Jan 1958 |
| Plan | GOLD PPO |
| Covered from | 15 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 75.40 |
| Total | 75.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001471 | 9 Jul 2025 | 882.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 882.00 |
| CLM0001470 | 22 Dec 2024 | 116.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 0.00 |
| CLM0001472 | 7 Sep 2024 | 410.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 410.00 |