GRACE KUMAR
Subscriber on policy B01M000590
Claims
3
Attributed to this person
Charged
1,150.00
Total submitted
Denied
394.00
2 denied claims
Patient responsibility
151.20
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 | GRACE KUMAR |
| Role on the policy | Subscriber |
| Policy | B01M000590 |
| Date of birth | 19 May 1956 |
| Plan | BRONZE EPO |
| Covered from | 20 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 151.20 |
| Total | 151.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002632 | 13 Mar 2026 | 321.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 321.00 |
| CLM0002631 | 14 Feb 2026 | 73.00 | CASCADE CARE | CARC 109 · COB | 73.00 |
| CLM0002633 | 30 Apr 2025 | 756.00 | CASCADE CARE | Not denied | — |