RAVI KUMAR
Dependent on policy B10M000683
Claims
3
Attributed to this person
Charged
1,446.00
Total submitted
Denied
495.11
2 denied claims
Patient responsibility
104.40
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 | RAVI KUMAR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000683 |
| Date of birth | 14 Sep 2008 |
| Plan | PLATINUM PPO |
| Covered from | 24 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 104.40 |
| Total | 104.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002842 | 26 Oct 2025 | 522.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002843 | 2 Mar 2025 | 757.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 328.11 |
| CLM0002844 | 17 Aug 2024 | 167.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 167.00 |