GRACE BAKER
Subscriber on policy B10M000526
Claims
3
Attributed to this person
Charged
1,882.00
Total submitted
Denied
704.16
2 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 | GRACE BAKER |
| Role on the policy | Subscriber |
| Policy | B10M000526 |
| Date of birth | 27 Mar 1971 |
| Plan | BRONZE EPO |
| Covered from | 7 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002173 | 16 Aug 2026 | 307.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002171 | 28 Jun 2025 | 876.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 5.16 |
| CLM0002172 | 20 Dec 2024 | 699.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 699.00 |