GRACE KUMAR
Subscriber on policy B03M000162
Claims
2
Attributed to this person
Charged
912.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
89.20
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 | B03M000162 |
| Date of birth | 20 Jan 1961 |
| Plan | BRONZE EPO |
| Covered from | 3 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 89.20 |
| Total | 89.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000662 | 27 Aug 2026 | 466.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000663 | 23 Aug 2025 | 446.00 | MERIDIAN HEALTH PLAN | Not denied | — |