ZARA KUMAR
Dependent on policy B08M000474
Claims
3
Attributed to this person
Charged
1,852.00
Total submitted
Denied
829.00
1 denied claims
Patient responsibility
29.55
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 | ZARA KUMAR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000474 |
| Date of birth | 25 Dec 2020 |
| Plan | BRONZE EPO |
| Covered from | 12 Jun 2024 |
| Covered to | 15 Jan 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 29.55 |
| Total | 29.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002207 | 5 Nov 2024 | 197.00 | CASCADE CARE | Not denied | — |
| CLM0002206 | 8 Oct 2024 | 826.00 | CASCADE CARE | Not denied | — |
| CLM0002208 | 3 Jun 2024 | 829.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 829.00 |