UMA KUMAR
Subscriber on policy B04M000337
Claims
2
Attributed to this person
Charged
468.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
148.20
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 | UMA KUMAR |
| Role on the policy | Subscriber |
| Policy | B04M000337 |
| Date of birth | 24 Feb 1984 |
| Plan | GOLD PPO |
| Covered from | 14 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 148.20 |
| Total | 148.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001459 | 11 Nov 2025 | 228.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0001460 | 29 Jun 2025 | 240.00 | NORTHSTAR MUTUAL | Not denied | — |