CARLA KUMAR
Dependent on policy B04M000645
Claims
2
Attributed to this person
Charged
420.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
30.00
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 | CARLA KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000645 |
| Date of birth | 14 Aug 2009 |
| Plan | GOLD PPO |
| Covered from | 26 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002806 | 11 Apr 2026 | 325.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002805 | 7 Aug 2025 | 95.00 | MERIDIAN HEALTH PLAN | Not denied | — |