HENRY BAKER
Subscriber on policy B05M000747
Claims
1
Attributed to this person
Charged
93.00
Total submitted
Denied
19.61
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 | HENRY BAKER |
| Role on the policy | Subscriber |
| Policy | B05M000747 |
| Date of birth | 9 Apr 1993 |
| Plan | PLATINUM PPO |
| Covered from | 28 Mar 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0003189 | 5 Jun 2024 | 93.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 19.61 |