OMAR BAKER
Dependent on policy B04M000877
Claims
3
Attributed to this person
Charged
1,432.00
Total submitted
Denied
852.00
2 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 | OMAR BAKER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000877 |
| Date of birth | 15 Apr 2016 |
| Plan | GOLD PPO |
| Covered from | 7 Oct 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 |
|---|---|---|---|---|---|
| CLM0003799 | 29 May 2026 | 162.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 162.00 |
| CLM0003800 | 10 Oct 2025 | 690.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 690.00 |
| CLM0003798 | 13 Aug 2025 | 580.00 | NORTHSTAR MUTUAL | Not denied | — |