GRACE KUMAR
Subscriber on policy B08M000474
Claims
3
Attributed to this person
Charged
2,205.00
Total submitted
Denied
888.00
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 | GRACE KUMAR |
| Role on the policy | Subscriber |
| Policy | B08M000474 |
| Date of birth | 6 May 1994 |
| Plan | BRONZE EPO |
| Covered from | 12 Jun 2024 |
| Covered to | 15 Jan 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 |
|---|---|---|---|---|---|
| CLM0002198 | 25 Dec 2024 | 748.00 | CASCADE CARE | Not denied | — |
| CLM0002199 | 17 Oct 2024 | 888.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 888.00 |
| CLM0002197 | 4 Aug 2024 | 569.00 | CASCADE CARE | Not denied | — |