TOMAS KUMAR
Dependent on policy B09M000431
Claims
2
Attributed to this person
Charged
966.00
Total submitted
Denied
245.53
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 | TOMAS KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000431 |
| Date of birth | 18 Sep 1960 |
| Plan | GOLD PPO |
| Covered from | 27 Jan 2024 |
| Covered to | 17 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 |
|---|---|---|---|---|---|
| CLM0001807 | 3 Sep 2024 | 567.00 | CASCADE CARE | CARC 11 · CODING | 245.53 |
| CLM0001806 | 16 Apr 2024 | 399.00 | CASCADE CARE | Not denied | — |