SOFIA KUMAR
Subscriber on policy B06M000137
Claims
3
Attributed to this person
Charged
1,016.00
Total submitted
Denied
149.00
2 denied claims
Patient responsibility
349.05
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 | SOFIA KUMAR |
| Role on the policy | Subscriber |
| Policy | B06M000137 |
| Date of birth | 5 Jul 1997 |
| Plan | SILVER HMO |
| Covered from | 7 Oct 2024 |
| Covered to | 25 May 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 349.05 |
| Total | 349.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000673 | 11 Jun 2025 | 149.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 149.00 |
| CLM0000671 | 16 Jan 2025 | 537.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000672 | 24 Oct 2024 | 330.00 | CASCADE CARE | Not denied | — |