CARLA BAKER
Subscriber on policy B05M000442
Claims
3
Attributed to this person
Charged
900.00
Total submitted
Denied
342.00
1 denied claims
Patient responsibility
20.25
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 | CARLA BAKER |
| Role on the policy | Subscriber |
| Policy | B05M000442 |
| Date of birth | 30 Dec 1985 |
| Plan | PLATINUM PPO |
| Covered from | 17 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 20.25 |
| Total | 20.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001864 | 11 Dec 2025 | 423.00 | CASCADE CARE | Not denied | — |
| CLM0001862 | 11 May 2025 | 135.00 | CASCADE CARE | Not denied | — |
| CLM0001863 | 29 Jun 2024 | 342.00 | CASCADE CARE | CARC 18 · DUPLICATE | 342.00 |