TOMAS IQBAL
Subscriber on policy B02M000771
Claims
2
Attributed to this person
Charged
946.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
90.90
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 | TOMAS IQBAL |
| Role on the policy | Subscriber |
| Policy | B02M000771 |
| Date of birth | 23 Dec 1993 |
| Plan | BRONZE EPO |
| Covered from | 5 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 90.90 |
| Total | 90.90 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003220 | 18 Sep 2025 | 340.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003221 | 23 Aug 2025 | 606.00 | NORTHSTAR MUTUAL | Not denied | — |