PRIYA KUMAR
Dependent on policy B08M000474
Claims
3
Attributed to this person
Charged
1,171.00
Total submitted
Denied
681.00
1 denied claims
Patient responsibility
20.00
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 | PRIYA KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000474 |
| Date of birth | 4 Sep 1996 |
| Plan | BRONZE EPO |
| Covered from | 12 Jun 2024 |
| Covered to | 15 Jan 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002200 | 13 Mar 2025 | 78.00 | CASCADE CARE | Not denied | — |
| CLM0002202 | 9 Jan 2025 | 681.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 681.00 |
| CLM0002201 | 14 Jul 2024 | 412.00 | CASCADE CARE | Not denied | — |