TOMAS IQBAL
Dependent on policy B07M000665
Claims
2
Attributed to this person
Charged
1,561.00
Total submitted
Denied
668.00
1 denied claims
Patient responsibility
50.00
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 | Dependent · relationship 19 |
| Policy | B07M000665 |
| Date of birth | 25 May 2004 |
| Plan | SILVER HMO |
| Covered from | 29 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002772 | 6 Jul 2025 | 668.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 668.00 |
| CLM0002773 | 11 Jan 2025 | 893.00 | MERIDIAN HEALTH PLAN | Not denied | — |