CARLA BAKER
Subscriber on policy B03M000798
Claims
1
Attributed to this person
Charged
741.00
Total submitted
Denied
741.00
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 | CARLA BAKER |
| Role on the policy | Subscriber |
| Policy | B03M000798 |
| Date of birth | 19 Dec 1970 |
| Plan | BRONZE EPO |
| Covered from | 1 Jun 2025 |
| Covered to | 7 Aug 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 |
|---|---|---|---|---|---|
| CLM0003409 | 30 Jun 2025 | 741.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 741.00 |