TOMAS KUMAR
Dependent on policy B10M000223
Claims
3
Attributed to this person
Charged
1,471.00
Total submitted
Denied
676.00
1 denied claims
Patient responsibility
0.00
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 | TOMAS KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000223 |
| Date of birth | 22 Feb 1963 |
| Plan | SILVER HMO |
| Covered from | 13 Jun 2024 |
| Covered to | 10 Sep 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000922 | 24 Sep 2024 | 480.00 | CASCADE CARE | Not denied | — |
| CLM0000924 | 9 Jul 2024 | 315.00 | CASCADE CARE | Not denied | — |
| CLM0000923 | 2 Jun 2024 | 676.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 676.00 |