YUSUF KUMAR
Subscriber on policy B03M000228
Claims
2
Attributed to this person
Charged
1,140.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
50.00
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 | YUSUF KUMAR |
| Role on the policy | Subscriber |
| Policy | B03M000228 |
| Date of birth | 21 Feb 1987 |
| Plan | BRONZE EPO |
| Covered from | 10 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000926 | 23 Dec 2024 | 791.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000927 | 6 Aug 2024 | 349.00 | MERIDIAN HEALTH PLAN | Not denied | — |