BRIAN IQBAL
Dependent on policy B02M000685
Claims
3
Attributed to this person
Charged
1,881.00
Total submitted
Denied
1,448.00
2 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 | BRIAN IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000685 |
| Date of birth | 26 Dec 2009 |
| Plan | GOLD PPO |
| Covered from | 20 Jul 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 |
|---|---|---|---|---|---|
| CLM0002895 | 14 Apr 2025 | 620.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 620.00 |
| CLM0002894 | 19 Feb 2025 | 433.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002896 | 5 Feb 2025 | 828.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 828.00 |