DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B01M000679›PRIYA IQBAL

PRIYA IQBAL

Dependent on policy B01M000679

Claims
2
Attributed to this person
Charged
399.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
116.35
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

FieldValue
NamePRIYA IQBAL
Role on the policyDependent · relationship 01
PolicyB01M000679
Date of birth4 Aug 1975
PlanSILVER HMO
Covered from2 Nov 2024
Covered to24 Jul 2025

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 50 · Other1116.35
Total116.35

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00030461 Mar 2025220.00CASCADE CARENot denied—
CLM000304510 Feb 2025179.00CASCADE CARECARC 50 · MEDICAL_NECESSITY0.00