AMARA BAKER
Dependent on policy B05M000113
Claims
3
Attributed to this person
Charged
2,018.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
121.80
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 | AMARA BAKER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000113 |
| Date of birth | 22 Oct 1961 |
| Plan | GOLD PPO |
| Covered from | 28 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 121.80 |
| Total | 121.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000474 | 31 Jul 2026 | 681.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000475 | 26 Jun 2026 | 728.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000476 | 29 Jul 2024 | 609.00 | MERIDIAN HEALTH PLAN | Not denied | — |