CARLA BAKER
Dependent on policy B01M000162
Claims
1
Attributed to this person
Charged
255.00
Total submitted
Denied
0.00
0 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 | Dependent · relationship 01 |
| Policy | B01M000162 |
| Date of birth | 28 Feb 1997 |
| Plan | BRONZE EPO |
| Covered from | 18 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000697 | 30 Aug 2025 | 255.00 | CASCADE CARE | Not denied | — |