FIONA BAKER
Subscriber on policy B08M000540
Claims
2
Attributed to this person
Charged
1,505.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
122.40
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 | FIONA BAKER |
| Role on the policy | Subscriber |
| Policy | B08M000540 |
| Date of birth | 3 May 2001 |
| Plan | BRONZE EPO |
| Covered from | 21 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 122.40 |
| Total | 122.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002480 | 4 Sep 2025 | 612.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002479 | 16 Jun 2025 | 893.00 | NORTHSTAR MUTUAL | Not denied | — |