PRIYA KUMAR
Dependent on policy B03M000849
Claims
2
Attributed to this person
Charged
964.00
Total submitted
Denied
714.93
2 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 | PRIYA KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000849 |
| Date of birth | 22 Jun 1975 |
| Plan | GOLD PPO |
| Covered from | 18 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003681 | 2 May 2026 | 589.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 589.00 |
| CLM0003680 | 28 Oct 2025 | 375.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 125.93 |