GRACE KUMAR
Subscriber on policy B10M000417
Claims
3
Attributed to this person
Charged
1,151.00
Total submitted
Denied
937.00
2 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 | GRACE KUMAR |
| Role on the policy | Subscriber |
| Policy | B10M000417 |
| Date of birth | 17 Jul 1989 |
| Plan | GOLD PPO |
| Covered from | 30 Jul 2024 |
| Covered to | 4 Dec 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 |
|---|---|---|---|---|---|
| CLM0001734 | 20 Aug 2024 | 214.00 | CASCADE CARE | Not denied | — |
| CLM0001735 | 23 Jul 2024 | 841.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 841.00 |
| CLM0001736 | 30 Jun 2024 | 96.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 96.00 |