TOMAS BAKER
Subscriber on policy B10M000151
Claims
2
Attributed to this person
Charged
764.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
9.15
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 | TOMAS BAKER |
| Role on the policy | Subscriber |
| Policy | B10M000151 |
| Date of birth | 9 Sep 1994 |
| Plan | BRONZE EPO |
| Covered from | 17 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 9.15 |
| Total | 9.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000615 | 7 Jul 2026 | 703.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000616 | 28 Apr 2026 | 61.00 | MERIDIAN HEALTH PLAN | Not denied | — |