KEVIN KUMAR
Dependent on policy B02M000702
Claims
2
Attributed to this person
Charged
1,442.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
177.80
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 | KEVIN KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000702 |
| Date of birth | 16 Aug 1958 |
| Plan | SILVER HMO |
| Covered from | 29 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 177.80 |
| Total | 177.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002958 | 14 Sep 2024 | 553.00 | CASCADE CARE | Not denied | — |
| CLM0002960 | 28 Apr 2024 | 889.00 | CASCADE CARE | Not denied | — |