AMARA KUMAR
Dependent on policy B03M000843
Claims
2
Attributed to this person
Charged
402.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
14.20
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 | AMARA KUMAR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000843 |
| Date of birth | 12 Sep 2015 |
| Plan | BRONZE EPO |
| Covered from | 7 Mar 2024 |
| Covered to | 19 Jul 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 14.20 |
| Total | 14.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003652 | 21 May 2024 | 331.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003653 | 29 Feb 2024 | 71.00 | MERIDIAN HEALTH PLAN | Not denied | — |