VICTOR IQBAL
Dependent on policy B10M000368
Claims
2
Attributed to this person
Charged
1,336.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
94.50
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 | VICTOR IQBAL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000368 |
| Date of birth | 26 Mar 1956 |
| Plan | GOLD PPO |
| Covered from | 15 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 94.50 |
| Total | 94.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001536 | 22 Apr 2025 | 630.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001535 | 2 Jan 2025 | 706.00 | NORTHSTAR MUTUAL | Not denied | — |