IVAN BAKER
Subscriber on policy B03M000002
Claims
1
Attributed to this person
Charged
185.00
Total submitted
Denied
185.00
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 | IVAN BAKER |
| Role on the policy | Subscriber |
| Policy | B03M000002 |
| Date of birth | 12 Jun 1955 |
| Plan | PLATINUM PPO |
| Covered from | 1 Jan 2024 |
| Covered to | 27 May 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000007 | 16 Feb 2024 | 185.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 185.00 |