LEILA KUMAR
Subscriber on policy B06M000174
Claims
2
Attributed to this person
Charged
598.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
58.20
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 | LEILA KUMAR |
| Role on the policy | Subscriber |
| Policy | B06M000174 |
| Date of birth | 7 May 1956 |
| Plan | PLATINUM PPO |
| Covered from | 12 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 58.20 |
| Total | 58.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000849 | 14 Dec 2025 | 210.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000850 | 8 Jul 2025 | 388.00 | NORTHSTAR MUTUAL | Not denied | — |