SOFIA IQBAL
Subscriber on policy B10M000678
Claims
1
Attributed to this person
Charged
757.00
Total submitted
Denied
757.00
1 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 | SOFIA IQBAL |
| Role on the policy | Subscriber |
| Policy | B10M000678 |
| Date of birth | 7 Oct 1987 |
| Plan | GOLD PPO |
| Covered from | 24 Jan 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 |
|---|---|---|---|---|---|
| CLM0002819 | 28 Mar 2024 | 757.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 757.00 |