TOMAS KUMAR
Subscriber on policy B03M000176
Claims
1
Attributed to this person
Charged
70.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
10.50
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 | Subscriber |
| Policy | B03M000176 |
| Date of birth | 23 Nov 1988 |
| Plan | BRONZE EPO |
| Covered from | 23 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 10.50 |
| Total | 10.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000716 | 24 Mar 2026 | 70.00 | MERIDIAN HEALTH PLAN | Not denied | — |