ZARA IQBAL
Dependent on policy B08M000691
Claims
3
Attributed to this person
Charged
1,203.00
Total submitted
Denied
1,042.00
2 denied claims
Patient responsibility
32.20
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 | ZARA IQBAL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000691 |
| Date of birth | 24 Sep 1974 |
| Plan | BRONZE EPO |
| Covered from | 14 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 32.20 |
| Total | 32.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003120 | 6 Aug 2026 | 146.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 146.00 |
| CLM0003119 | 28 Jul 2026 | 161.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003118 | 10 Jul 2024 | 896.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 896.00 |