RAVI KUMAR
Dependent on policy B04M000215
Claims
3
Attributed to this person
Charged
1,749.00
Total submitted
Denied
210.28
1 denied claims
Patient responsibility
111.45
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 | RAVI KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000215 |
| Date of birth | 24 Jan 1986 |
| Plan | BRONZE EPO |
| Covered from | 3 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 111.45 |
| Total | 111.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000947 | 13 Nov 2025 | 891.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 210.28 |
| CLM0000948 | 16 Sep 2025 | 115.00 | CASCADE CARE | Not denied | — |
| CLM0000949 | 2 Apr 2025 | 743.00 | CASCADE CARE | Not denied | — |