CARLA KUMAR
Subscriber on policy B08M000896
Claims
2
Attributed to this person
Charged
793.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
89.25
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 | CARLA KUMAR |
| Role on the policy | Subscriber |
| Policy | B08M000896 |
| Date of birth | 3 Mar 1967 |
| Plan | PLATINUM PPO |
| Covered from | 28 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 89.25 |
| Total | 89.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0004006 | 11 Nov 2025 | 198.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0004007 | 28 Nov 2024 | 595.00 | NORTHSTAR MUTUAL | Not denied | — |