LEILA BAKER
Subscriber on policy B07M000287
Claims
3
Attributed to this person
Charged
1,612.00
Total submitted
Denied
1,088.00
2 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 | LEILA BAKER |
| Role on the policy | Subscriber |
| Policy | B07M000287 |
| Date of birth | 25 Mar 1951 |
| Plan | BRONZE EPO |
| Covered from | 10 Mar 2024 |
| Covered to | 5 Nov 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 |
|---|---|---|---|---|---|
| CLM0001244 | 24 Dec 2024 | 655.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 655.00 |
| CLM0001245 | 22 Aug 2024 | 524.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001246 | 7 May 2024 | 433.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 433.00 |