LEILA KUMAR
Subscriber on policy B10M000201
Claims
1
Attributed to this person
Charged
676.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
439.40
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 | LEILA KUMAR |
| Role on the policy | Subscriber |
| Policy | B10M000201 |
| Date of birth | 21 Jan 1958 |
| Plan | SILVER HMO |
| Covered from | 9 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 439.40 |
| Total | 439.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000828 | 10 Aug 2026 | 676.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |