PRIYA BAKER
Subscriber on policy B04M000764
Claims
2
Attributed to this person
Charged
874.00
Total submitted
Denied
203.50
1 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 | PRIYA BAKER |
| Role on the policy | Subscriber |
| Policy | B04M000764 |
| Date of birth | 13 Jan 1991 |
| Plan | GOLD PPO |
| Covered from | 7 Oct 2024 |
| Covered to | 6 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003324 | 22 Mar 2025 | 579.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 203.50 |
| CLM0003323 | 9 Feb 2025 | 295.00 | CASCADE CARE | Not denied | — |