UMA BAKER
Subscriber on policy B04M000545
Claims
2
Attributed to this person
Charged
721.00
Total submitted
Denied
721.00
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 | UMA BAKER |
| Role on the policy | Subscriber |
| Policy | B04M000545 |
| Date of birth | 9 Oct 1980 |
| Plan | BRONZE EPO |
| Covered from | 20 Jan 2024 |
| Covered to | 9 Apr 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002393 | 25 Jan 2024 | 292.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 292.00 |
| CLM0002394 | 5 Jan 2024 | 429.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 429.00 |