RAVI KUMAR
Subscriber on policy B01M000844
Claims
2
Attributed to this person
Charged
1,022.00
Total submitted
Denied
522.00
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 | RAVI KUMAR |
| Role on the policy | Subscriber |
| Policy | B01M000844 |
| Date of birth | 4 Feb 1988 |
| Plan | PLATINUM PPO |
| Covered from | 15 Nov 2024 |
| Covered to | 21 Jul 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003742 | 28 May 2025 | 500.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003743 | 3 May 2025 | 522.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 522.00 |