LEILA KUMAR
Subscriber on policy B03M000297
Claims
1
Attributed to this person
Charged
123.00
Total submitted
Denied
123.00
1 denied claims
Patient responsibility
0.00
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 | LEILA KUMAR |
| Role on the policy | Subscriber |
| Policy | B03M000297 |
| Date of birth | 6 Apr 1972 |
| Plan | BRONZE EPO |
| Covered from | 13 Jun 2024 |
| Covered to | 12 Dec 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001189 | 24 Dec 2024 | 123.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 123.00 |