X12 Ingest & Denial Analytics

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Members›policy B01M000364›AMARA IQBAL

AMARA IQBAL

Dependent on policy B01M000364

Claims
3
Attributed to this person
Charged
1,326.00
Total submitted
Denied
804.00
1 denied claims
Patient responsibility
31.20
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

FieldValue
NameAMARA IQBAL
Role on the policyDependent · relationship 19
PolicyB01M000364
Date of birth26 Feb 1999
PlanPLATINUM PPO
Covered from3 Apr 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 1 · Deductible131.20
Total31.20

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000162012 Apr 2026208.00MERIDIAN HEALTH PLANNot denied—
CLM000161814 Feb 2026314.00MERIDIAN HEALTH PLANNot denied—
CLM000161924 May 2024804.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY804.00