TOMAS IQBAL
Subscriber on policy B06M000034
Claims
2
Attributed to this person
Charged
896.00
Total submitted
Denied
707.00
1 denied claims
Patient responsibility
28.35
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 | TOMAS IQBAL |
| Role on the policy | Subscriber |
| Policy | B06M000034 |
| Date of birth | 18 Sep 1967 |
| Plan | PLATINUM PPO |
| Covered from | 10 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 28.35 |
| Total | 28.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000195 | 18 Jan 2025 | 189.00 | CASCADE CARE | Not denied | — |
| CLM0000196 | 12 Mar 2024 | 707.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 707.00 |