ELENA IQBAL
Dependent on policy B02M000799
Claims
1
Attributed to this person
Charged
446.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
30.00
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 | ELENA IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000799 |
| Date of birth | 2 Mar 2023 |
| Plan | SILVER HMO |
| Covered from | 13 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003345 | 29 May 2024 | 446.00 | MERIDIAN HEALTH PLAN | Not denied | — |