NADIA KUMAR
Dependent on policy B04M000645
Claims
1
Attributed to this person
Charged
849.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
551.85
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 | NADIA KUMAR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000645 |
| Date of birth | 21 Apr 2020 |
| Plan | GOLD PPO |
| Covered from | 26 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 551.85 |
| Total | 551.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002810 | 4 Dec 2025 | 849.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |