ELENA KUMAR
Subscriber on policy B04M000269
Claims
2
Attributed to this person
Charged
479.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
41.40
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 | ELENA KUMAR |
| Role on the policy | Subscriber |
| Policy | B04M000269 |
| Date of birth | 27 Jun 1970 |
| Plan | SILVER HMO |
| Covered from | 3 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 41.40 |
| Total | 41.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001163 | 7 Jun 2025 | 272.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001164 | 31 Mar 2025 | 207.00 | MERIDIAN HEALTH PLAN | Not denied | — |