CARLA IQBAL
Subscriber on policy B01M000834
Claims
1
Attributed to this person
Charged
169.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
25.00
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 | CARLA IQBAL |
| Role on the policy | Subscriber |
| Policy | B01M000834 |
| Date of birth | 1 Nov 1951 |
| Plan | BRONZE EPO |
| Covered from | 5 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003702 | 20 Aug 2025 | 169.00 | CASCADE CARE | Not denied | — |