FIONA IQBAL
Dependent on policy B06M000018
Claims
1
Attributed to this person
Charged
377.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
75.40
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 | FIONA IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000018 |
| Date of birth | 21 Oct 2002 |
| Plan | GOLD PPO |
| Covered from | 18 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 75.40 |
| Total | 75.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000114 | 7 Feb 2025 | 377.00 | NORTHSTAR MUTUAL | Not denied | — |