HENRY BAKER
Subscriber on policy B01M000778
Claims
3
Attributed to this person
Charged
1,551.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
114.40
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 | HENRY BAKER |
| Role on the policy | Subscriber |
| Policy | B01M000778 |
| Date of birth | 27 Jun 1955 |
| Plan | PLATINUM PPO |
| Covered from | 17 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 114.40 |
| Total | 114.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003463 | 12 Mar 2026 | 819.00 | CASCADE CARE | Not denied | — |
| CLM0003465 | 5 Sep 2025 | 556.00 | CASCADE CARE | Not denied | — |
| CLM0003464 | 10 Jun 2025 | 176.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |