GRACE KUMAR
Dependent on policy B07M000380
Claims
2
Attributed to this person
Charged
793.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
148.85
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 | GRACE KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000380 |
| Date of birth | 24 Dec 1984 |
| Plan | SILVER HMO |
| Covered from | 14 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 148.85 |
| Total | 148.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001617 | 12 Mar 2026 | 229.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0001618 | 3 Jan 2026 | 564.00 | CASCADE CARE | Not denied | — |