GRACE BAKER
Subscriber on policy B02M000337
Claims
2
Attributed to this person
Charged
533.00
Total submitted
Denied
220.00
1 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 | B02M000337 |
| Date of birth | 14 Apr 1999 |
| Plan | GOLD PPO |
| Covered from | 23 Apr 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 |
|---|---|---|---|---|---|
| CLM0001432 | 1 Jul 2026 | 220.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 220.00 |
| CLM0001431 | 14 Jul 2025 | 313.00 | NORTHSTAR MUTUAL | Not denied | — |