LEILA KUMAR
Dependent on policy B10M000209
Claims
3
Attributed to this person
Charged
1,418.00
Total submitted
Denied
676.81
2 denied claims
Patient responsibility
75.60
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 | Dependent · relationship 19 |
| Policy | B10M000209 |
| Date of birth | 18 Nov 2019 |
| Plan | SILVER HMO |
| Covered from | 6 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 75.60 |
| Total | 75.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000852 | 6 Jun 2026 | 421.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 421.00 |
| CLM0000853 | 3 Jul 2025 | 378.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000851 | 4 Sep 2024 | 619.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 255.81 |