VICTOR KUMAR
Dependent on policy B09M000663
Claims
2
Attributed to this person
Charged
1,153.00
Total submitted
Denied
531.00
1 denied claims
Patient responsibility
93.30
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 | VICTOR KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000663 |
| Date of birth | 18 Mar 1996 |
| Plan | PLATINUM PPO |
| Covered from | 11 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 93.30 |
| Total | 93.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002818 | 27 Apr 2025 | 622.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002817 | 1 Mar 2025 | 531.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 531.00 |