KEVIN BAKER
Subscriber on policy B04M000066
Claims
1
Attributed to this person
Charged
336.00
Total submitted
Denied
336.00
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 | KEVIN BAKER |
| Role on the policy | Subscriber |
| Policy | B04M000066 |
| Date of birth | 2 Apr 1984 |
| Plan | SILVER HMO |
| Covered from | 14 Jan 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0000286 | 14 Sep 2024 | 336.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 336.00 |