HENRY BAKER
Subscriber on policy B02M000023
Claims
1
Attributed to this person
Charged
390.00
Total submitted
Denied
390.00
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 | HENRY BAKER |
| Role on the policy | Subscriber |
| Policy | B02M000023 |
| Date of birth | 17 May 2000 |
| Plan | BRONZE EPO |
| Covered from | 15 Dec 2024 |
| Covered to | 14 Feb 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 |
|---|---|---|---|---|---|
| CLM0000126 | 25 Jan 2025 | 390.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 390.00 |