PRIYA KUMAR
Subscriber on policy B07M000207
Claims
3
Attributed to this person
Charged
908.00
Total submitted
Denied
815.00
3 denied claims
Patient responsibility
60.45
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 | PRIYA KUMAR |
| Role on the policy | Subscriber |
| Policy | B07M000207 |
| Date of birth | 5 Jul 1977 |
| Plan | SILVER HMO |
| Covered from | 1 Apr 2025 |
| Covered to | 29 Jul 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 60.45 |
| Total | 60.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000867 | 11 Sep 2025 | 93.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000866 | 4 Sep 2025 | 588.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 588.00 |
| CLM0000868 | 21 Aug 2025 | 227.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 227.00 |