PRIYA BAKER
Subscriber on policy B09M000007
Claims
2
Attributed to this person
Charged
564.00
Total submitted
Denied
224.00
1 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 | PRIYA BAKER |
| Role on the policy | Subscriber |
| Policy | B09M000007 |
| Date of birth | 16 Dec 1954 |
| Plan | GOLD PPO |
| Covered from | 7 Mar 2024 |
| Covered to | 28 Dec 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 |
|---|---|---|---|---|---|
| CLM0000024 | 25 Aug 2024 | 224.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 224.00 |
| CLM0000025 | 22 Jul 2024 | 340.00 | NORTHSTAR MUTUAL | Not denied | — |