GRACE BAKER
Dependent on policy B03M000339
Claims
1
Attributed to this person
Charged
155.00
Total submitted
Denied
0.00
0 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 | Dependent · relationship 19 |
| Policy | B03M000339 |
| Date of birth | 20 Feb 2006 |
| Plan | GOLD PPO |
| Covered from | 23 Oct 2024 |
| Covered to | 25 Jul 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 |
|---|---|---|---|---|---|
| CLM0001365 | 25 Dec 2024 | 155.00 | CASCADE CARE | Not denied | — |