SOFIA KUMAR
Subscriber on policy B01M000041
Claims
1
Attributed to this person
Charged
495.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
0.00
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 | SOFIA KUMAR |
| Role on the policy | Subscriber |
| Policy | B01M000041 |
| Date of birth | 2 Mar 1992 |
| Plan | GOLD PPO |
| Covered from | 2 Jan 2024 |
| Covered to | 27 Mar 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000158 | 25 Feb 2024 | 495.00 | NORTHSTAR MUTUAL | Not denied | — |