IVAN BAKER
Dependent on policy B04M000529
Claims
3
Attributed to this person
Charged
1,786.00
Total submitted
Denied
788.00
1 denied claims
Patient responsibility
103.35
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 | Dependent · relationship 19 |
| Policy | B04M000529 |
| Date of birth | 4 Jul 2017 |
| Plan | SILVER HMO |
| Covered from | 6 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 103.35 |
| Total | 103.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002299 | 26 Nov 2025 | 309.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002300 | 23 May 2025 | 788.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 788.00 |
| CLM0002298 | 15 Mar 2025 | 689.00 | MERIDIAN HEALTH PLAN | Not denied | — |