RAVI KUMAR
Subscriber on policy B05M000738
Claims
3
Attributed to this person
Charged
1,632.00
Total submitted
Denied
343.00
1 denied claims
Patient responsibility
101.40
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 | Subscriber |
| Policy | B05M000738 |
| Date of birth | 19 Dec 1994 |
| Plan | PLATINUM PPO |
| Covered from | 16 Dec 2024 |
| Covered to | 14 Apr 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 101.40 |
| Total | 101.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003142 | 29 Apr 2025 | 676.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003141 | 16 Apr 2025 | 343.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 343.00 |
| CLM0003140 | 23 Dec 2024 | 613.00 | MERIDIAN HEALTH PLAN | Not denied | — |