UMA IQBAL
Subscriber on policy B02M000784
Claims
3
Attributed to this person
Charged
1,671.00
Total submitted
Denied
171.72
1 denied claims
Patient responsibility
109.00
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 | UMA IQBAL |
| Role on the policy | Subscriber |
| Policy | B02M000784 |
| Date of birth | 14 Dec 2001 |
| Plan | BRONZE EPO |
| Covered from | 9 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 109.00 |
| Total | 109.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003272 | 9 Jul 2026 | 662.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 171.72 |
| CLM0003271 | 24 Jan 2025 | 545.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003273 | 3 Dec 2024 | 464.00 | MERIDIAN HEALTH PLAN | Not denied | — |