ELENA BAKER
Subscriber on policy B08M000744
Claims
2
Attributed to this person
Charged
1,127.00
Total submitted
Denied
161.14
1 denied claims
Patient responsibility
98.10
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 | ELENA BAKER |
| Role on the policy | Subscriber |
| Policy | B08M000744 |
| Date of birth | 18 Nov 2003 |
| Plan | BRONZE EPO |
| Covered from | 28 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 98.10 |
| Total | 98.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003333 | 24 Oct 2025 | 473.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 161.14 |
| CLM0003334 | 2 Apr 2025 | 654.00 | MERIDIAN HEALTH PLAN | Not denied | — |