DAVID BAKER
Subscriber on policy B05M000369
Claims
3
Attributed to this person
Charged
1,420.00
Total submitted
Denied
645.00
1 denied claims
Patient responsibility
106.65
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 | DAVID BAKER |
| Role on the policy | Subscriber |
| Policy | B05M000369 |
| Date of birth | 28 Nov 2000 |
| Plan | PLATINUM PPO |
| Covered from | 26 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 106.65 |
| Total | 106.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001568 | 8 Mar 2026 | 711.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001569 | 13 Dec 2025 | 64.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001570 | 24 Oct 2025 | 645.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 645.00 |