OMAR BAKER
Dependent on policy B09M000007
Claims
2
Attributed to this person
Charged
769.00
Total submitted
Denied
586.00
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 | OMAR BAKER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000007 |
| Date of birth | 20 Dec 1998 |
| 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 |
|---|---|---|---|---|---|
| CLM0000029 | 9 Feb 2025 | 586.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 586.00 |
| CLM0000030 | 2 Dec 2024 | 183.00 | NORTHSTAR MUTUAL | Not denied | — |