AMARA IQBAL
Subscriber on policy B10M000733
Claims
1
Attributed to this person
Charged
248.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
161.20
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 | B10M000733 |
| Date of birth | 14 Mar 1970 |
| Plan | BRONZE EPO |
| Covered from | 18 Nov 2024 |
| Covered to | 1 Apr 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 161.20 |
| Total | 161.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003070 | 13 Nov 2024 | 248.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |