KEVIN IQBAL
Dependent on policy B10M000487
Claims
2
Attributed to this person
Charged
759.00
Total submitted
Denied
106.00
1 denied claims
Patient responsibility
97.95
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 | KEVIN IQBAL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000487 |
| Date of birth | 1 Sep 1979 |
| Plan | GOLD PPO |
| Covered from | 14 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 97.95 |
| Total | 97.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002017 | 23 Jun 2025 | 106.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 106.00 |
| CLM0002016 | 26 Nov 2024 | 653.00 | NORTHSTAR MUTUAL | Not denied | — |