KEVIN BAKER
Subscriber on policy B04M000746
Claims
1
Attributed to this person
Charged
730.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
109.50
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 | B04M000746 |
| Date of birth | 24 Mar 1998 |
| Plan | GOLD PPO |
| Covered from | 14 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 109.50 |
| Total | 109.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003261 | 10 Jan 2026 | 730.00 | MERIDIAN HEALTH PLAN | Not denied | — |