RAVI KUMAR
Dependent on policy B03M000420
Claims
3
Attributed to this person
Charged
1,188.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
56.40
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 01 |
| Policy | B03M000420 |
| Date of birth | 4 Oct 1999 |
| Plan | BRONZE EPO |
| Covered from | 25 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 56.40 |
| Total | 56.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001708 | 5 Jan 2026 | 246.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001710 | 21 Oct 2025 | 282.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001709 | 9 Mar 2024 | 660.00 | NORTHSTAR MUTUAL | Not denied | — |