HENRY KUMAR
Dependent on policy B05M000288
Claims
2
Attributed to this person
Charged
977.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
232.70
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 | HENRY KUMAR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000288 |
| Date of birth | 9 Jan 1949 |
| Plan | SILVER HMO |
| Covered from | 19 Oct 2024 |
| Covered to | 28 Jul 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 232.70 |
| Total | 232.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001192 | 24 May 2025 | 619.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001193 | 5 Apr 2025 | 358.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |