WENDY BAKER
Subscriber on policy B07M000187
Claims
3
Attributed to this person
Charged
1,673.00
Total submitted
Denied
667.00
1 denied claims
Patient responsibility
117.60
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 | WENDY BAKER |
| Role on the policy | Subscriber |
| Policy | B07M000187 |
| Date of birth | 24 Jan 1967 |
| Plan | BRONZE EPO |
| Covered from | 19 Mar 2025 |
| Covered to | 6 Nov 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 117.60 |
| Total | 117.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000779 | 8 Nov 2025 | 667.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 667.00 |
| CLM0000781 | 25 Jun 2025 | 784.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000780 | 30 Apr 2025 | 222.00 | NORTHSTAR MUTUAL | Not denied | — |