UMA BAKER
Subscriber on policy B02M000276
Claims
3
Attributed to this person
Charged
1,072.00
Total submitted
Denied
604.03
3 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 | B02M000276 |
| Date of birth | 16 May 1960 |
| Plan | GOLD PPO |
| Covered from | 12 Nov 2024 |
| Covered to | 16 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001203 | 28 Apr 2025 | 316.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 316.00 |
| CLM0001204 | 9 Jan 2025 | 101.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 101.00 |
| CLM0001205 | 21 Nov 2024 | 655.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 187.03 |