UMA BAKER
Subscriber on policy B10M000194
Claims
3
Attributed to this person
Charged
1,105.00
Total submitted
Denied
365.00
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 | UMA BAKER |
| Role on the policy | Subscriber |
| Policy | B10M000194 |
| Date of birth | 29 Jun 2003 |
| Plan | GOLD PPO |
| Covered from | 22 Feb 2024 |
| Covered to | 30 Sep 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 |
|---|---|---|---|---|---|
| CLM0000801 | 1 Nov 2024 | 365.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 365.00 |
| CLM0000802 | 12 Jul 2024 | 648.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000800 | 24 May 2024 | 92.00 | MERIDIAN HEALTH PLAN | Not denied | — |