AMARA IQBAL
Subscriber on policy B01M000815
Claims
2
Attributed to this person
Charged
1,520.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
484.90
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 | AMARA IQBAL |
| Role on the policy | Subscriber |
| Policy | B01M000815 |
| Date of birth | 13 Sep 1951 |
| Plan | GOLD PPO |
| Covered from | 2 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 484.90 |
| Total | 484.90 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003621 | 8 Sep 2024 | 774.00 | CASCADE CARE | Not denied | — |
| CLM0003620 | 25 Feb 2024 | 746.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |