RAVI KUMAR
Dependent on policy B09M000163
Claims
2
Attributed to this person
Charged
861.00
Total submitted
Denied
610.00
1 denied claims
Patient responsibility
50.20
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 | RAVI KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000163 |
| Date of birth | 14 Sep 1991 |
| Plan | SILVER HMO |
| Covered from | 21 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 50.20 |
| Total | 50.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000678 | 22 Feb 2026 | 610.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 610.00 |
| CLM0000677 | 16 Feb 2025 | 251.00 | CASCADE CARE | Not denied | — |