PRIYA BAKER
Subscriber on policy B10M000833
Claims
2
Attributed to this person
Charged
181.00
Total submitted
Denied
67.00
1 denied claims
Patient responsibility
22.80
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 | PRIYA BAKER |
| Role on the policy | Subscriber |
| Policy | B10M000833 |
| Date of birth | 11 Sep 1988 |
| Plan | GOLD PPO |
| Covered from | 23 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 22.80 |
| Total | 22.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003531 | 15 Nov 2025 | 114.00 | CASCADE CARE | Not denied | — |
| CLM0003530 | 9 Oct 2025 | 67.00 | CASCADE CARE | CARC 11 · CODING | 67.00 |