GRACE IQBAL
Subscriber on policy B02M000667
Claims
3
Attributed to this person
Charged
1,200.00
Total submitted
Denied
80.00
2 denied claims
Patient responsibility
210.60
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 | GRACE IQBAL |
| Role on the policy | Subscriber |
| Policy | B02M000667 |
| Date of birth | 23 Oct 1974 |
| Plan | BRONZE EPO |
| Covered from | 27 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 210.60 |
| Total | 210.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002810 | 21 Apr 2026 | 796.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002811 | 5 Mar 2025 | 324.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0002812 | 15 Dec 2024 | 80.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 80.00 |