OMAR KUMAR
Subscriber on policy B10M000257
Claims
3
Attributed to this person
Charged
1,627.00
Total submitted
Denied
1,410.00
2 denied claims
Patient responsibility
43.40
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 | OMAR KUMAR |
| Role on the policy | Subscriber |
| Policy | B10M000257 |
| Date of birth | 17 Apr 1996 |
| Plan | PLATINUM PPO |
| Covered from | 12 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 43.40 |
| Total | 43.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001053 | 13 Jun 2025 | 217.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001051 | 4 Mar 2025 | 804.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 804.00 |
| CLM0001052 | 1 Feb 2025 | 606.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 606.00 |