RAVI KUMAR
Dependent on policy B03M000056
Claims
3
Attributed to this person
Charged
1,685.00
Total submitted
Denied
292.38
1 denied claims
Patient responsibility
111.15
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 | RAVI KUMAR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000056 |
| Date of birth | 26 Dec 1998 |
| Plan | SILVER HMO |
| Covered from | 26 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 111.15 |
| Total | 111.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000241 | 22 Apr 2026 | 586.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 292.38 |
| CLM0000243 | 24 Jul 2025 | 358.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000242 | 24 Dec 2024 | 741.00 | NORTHSTAR MUTUAL | Not denied | — |