SOFIA BAKER
Dependent on policy B06M000643
Claims
2
Attributed to this person
Charged
1,224.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
132.60
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 | SOFIA BAKER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000643 |
| Date of birth | 23 Oct 2000 |
| Plan | GOLD PPO |
| Covered from | 25 Jul 2024 |
| Covered to | 5 May 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 132.60 |
| Total | 132.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002855 | 7 Jun 2025 | 884.00 | CASCADE CARE | Not denied | — |
| CLM0002856 | 8 Apr 2025 | 340.00 | CASCADE CARE | Not denied | — |