OMAR KUMAR
Dependent on policy B08M000743
Claims
2
Attributed to this person
Charged
1,438.00
Total submitted
Denied
794.00
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 | OMAR KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000743 |
| Date of birth | 4 Nov 1966 |
| Plan | GOLD PPO |
| Covered from | 18 Jun 2024 |
| Covered to | 2 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003323 | 6 Aug 2024 | 644.00 | CASCADE CARE | Not denied | — |
| CLM0003324 | 26 May 2024 | 794.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 794.00 |