JULIA KUMAR
Dependent on policy B03M000849
Claims
3
Attributed to this person
Charged
1,253.00
Total submitted
Denied
804.00
2 denied claims
Patient responsibility
211.25
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 | JULIA KUMAR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000849 |
| Date of birth | 18 Dec 1998 |
| Plan | GOLD PPO |
| Covered from | 18 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 211.25 |
| Total | 211.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003682 | 28 Aug 2026 | 124.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003683 | 21 Jun 2026 | 804.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 804.00 |
| CLM0003684 | 15 Sep 2025 | 325.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 0.00 |