RAVI KUMAR
Subscriber on policy B04M000076
Claims
1
Attributed to this person
Charged
860.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
172.00
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 | RAVI KUMAR |
| Role on the policy | Subscriber |
| Policy | B04M000076 |
| Date of birth | 31 May 1987 |
| Plan | GOLD PPO |
| Covered from | 11 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 172.00 |
| Total | 172.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000352 | 8 Mar 2025 | 860.00 | MERIDIAN HEALTH PLAN | Not denied | — |