CARLA BAKER
Subscriber on policy B07M000132
Claims
1
Attributed to this person
Charged
870.00
Total submitted
Denied
870.00
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 | CARLA BAKER |
| Role on the policy | Subscriber |
| Policy | B07M000132 |
| Date of birth | 10 Sep 1967 |
| Plan | BRONZE EPO |
| Covered from | 5 Jan 2024 |
| Covered to | 26 Jun 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000549 | 20 Jul 2024 | 870.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 870.00 |