DAVID IQBAL
Subscriber on policy B10M000268
Claims
3
Attributed to this person
Charged
1,860.00
Total submitted
Denied
463.00
1 denied claims
Patient responsibility
88.80
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 | DAVID IQBAL |
| Role on the policy | Subscriber |
| Policy | B10M000268 |
| Date of birth | 23 Dec 1982 |
| Plan | BRONZE EPO |
| Covered from | 22 Sep 2024 |
| Covered to | 30 Jan 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 88.80 |
| Total | 88.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001110 | 22 Nov 2024 | 805.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001111 | 8 Nov 2024 | 463.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 463.00 |
| CLM0001112 | 26 Aug 2024 | 592.00 | MERIDIAN HEALTH PLAN | Not denied | — |