MARCUS KUMAR
Subscriber on policy B10M000271
Claims
2
Attributed to this person
Charged
1,411.00
Total submitted
Denied
686.00
1 denied claims
Patient responsibility
145.00
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 | MARCUS KUMAR |
| Role on the policy | Subscriber |
| Policy | B10M000271 |
| Date of birth | 29 Aug 1958 |
| Plan | SILVER HMO |
| Covered from | 6 Jan 2024 |
| Covered to | 1 Aug 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 145.00 |
| Total | 145.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001125 | 17 Sep 2024 | 686.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 686.00 |
| CLM0001126 | 9 Aug 2024 | 725.00 | NORTHSTAR MUTUAL | Not denied | — |