TOMAS IQBAL
Dependent on policy B08M000808
Claims
2
Attributed to this person
Charged
1,466.00
Total submitted
Denied
1,005.08
2 denied claims
Patient responsibility
0.00
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 | B08M000808 |
| Date of birth | 12 Apr 2010 |
| Plan | GOLD PPO |
| Covered from | 3 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003614 | 30 Mar 2025 | 636.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 175.08 |
| CLM0003613 | 6 Feb 2025 | 830.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 830.00 |