FIONA KUMAR
Dependent on policy B10M000881
Claims
2
Attributed to this person
Charged
547.00
Total submitted
Denied
306.00
2 denied claims
Patient responsibility
156.65
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 | FIONA KUMAR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000881 |
| Date of birth | 20 Jun 2019 |
| Plan | SILVER HMO |
| Covered from | 3 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 156.65 |
| Total | 156.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003749 | 29 Jun 2026 | 306.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 306.00 |
| CLM0003748 | 10 Oct 2025 | 241.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |