WENDY KUMAR
Subscriber on policy B10M000223
Claims
3
Attributed to this person
Charged
1,436.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
112.95
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 | WENDY KUMAR |
| Role on the policy | Subscriber |
| Policy | B10M000223 |
| Date of birth | 26 Mar 1967 |
| Plan | SILVER HMO |
| Covered from | 13 Jun 2024 |
| Covered to | 10 Sep 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 2 | 112.95 |
| Total | 112.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000921 | 20 Sep 2024 | 127.00 | CASCADE CARE | Not denied | — |
| CLM0000920 | 15 Sep 2024 | 626.00 | CASCADE CARE | Not denied | — |
| CLM0000919 | 7 Aug 2024 | 683.00 | CASCADE CARE | Not denied | — |