FIONA KUMAR
Dependent on policy B10M000430
Claims
1
Attributed to this person
Charged
132.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
26.40
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 | FIONA KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000430 |
| Date of birth | 6 Jan 1961 |
| Plan | BRONZE EPO |
| Covered from | 18 Apr 2025 |
| Covered to | 22 Oct 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 26.40 |
| Total | 26.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001788 | 12 Jul 2025 | 132.00 | NORTHSTAR MUTUAL | Not denied | — |