OMAR BAKER
Dependent on policy B07M000285
Claims
1
Attributed to this person
Charged
762.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
114.30
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 | OMAR BAKER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000285 |
| Date of birth | 20 Mar 1996 |
| Plan | PLATINUM PPO |
| Covered from | 15 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 114.30 |
| Total | 114.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001241 | 28 Nov 2025 | 762.00 | NORTHSTAR MUTUAL | Not denied | — |