IVAN KUMAR
Dependent on policy B02M000104
Claims
2
Attributed to this person
Charged
679.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
30.00
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 | IVAN KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000104 |
| Date of birth | 21 Aug 1948 |
| Plan | PLATINUM PPO |
| Covered from | 20 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000469 | 22 Jun 2026 | 199.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000470 | 26 May 2026 | 480.00 | MERIDIAN HEALTH PLAN | Not denied | — |