GRACE BAKER
Subscriber on policy B04M000803
Claims
2
Attributed to this person
Charged
823.00
Total submitted
Denied
102.00
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 | GRACE BAKER |
| Role on the policy | Subscriber |
| Policy | B04M000803 |
| Date of birth | 6 Oct 1956 |
| Plan | PLATINUM PPO |
| Covered from | 23 Jun 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003505 | 11 Aug 2026 | 721.00 | CASCADE CARE | Not denied | — |
| CLM0003504 | 15 Jun 2026 | 102.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 102.00 |