UMA BAKER
Dependent on policy B04M000677
Claims
3
Attributed to this person
Charged
1,560.00
Total submitted
Denied
273.00
1 denied claims
Patient responsibility
94.95
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 | UMA BAKER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000677 |
| Date of birth | 2 Jun 1975 |
| Plan | BRONZE EPO |
| Covered from | 8 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 94.95 |
| Total | 94.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002952 | 4 Aug 2026 | 633.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002953 | 3 Oct 2025 | 273.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 273.00 |
| CLM0002951 | 14 Feb 2025 | 654.00 | MERIDIAN HEALTH PLAN | Not denied | — |