OMAR BAKER
Subscriber on policy B02M000422
Claims
3
Attributed to this person
Charged
444.00
Total submitted
Denied
207.00
2 denied claims
Patient responsibility
35.55
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 | OMAR BAKER |
| Role on the policy | Subscriber |
| Policy | B02M000422 |
| Date of birth | 7 Dec 1972 |
| Plan | GOLD PPO |
| Covered from | 3 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 35.55 |
| Total | 35.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001802 | 6 Jan 2026 | 136.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 136.00 |
| CLM0001800 | 11 Oct 2025 | 71.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 71.00 |
| CLM0001801 | 17 Jun 2025 | 237.00 | MERIDIAN HEALTH PLAN | Not denied | — |