AMARA BAKER
Subscriber on policy B09M000182
Claims
3
Attributed to this person
Charged
1,121.00
Total submitted
Denied
839.00
2 denied claims
Patient responsibility
119.55
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 | AMARA BAKER |
| Role on the policy | Subscriber |
| Policy | B09M000182 |
| Date of birth | 2 Jul 1972 |
| Plan | GOLD PPO |
| Covered from | 15 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 69.55 |
| CARC 3 · Copay | 1 | 50.00 |
| Total | 119.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000765 | 18 Aug 2026 | 839.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 839.00 |
| CLM0000764 | 8 Oct 2025 | 175.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000766 | 13 Jun 2025 | 107.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |