TOMAS IQBAL
Dependent on policy B03M000239
Claims
3
Attributed to this person
Charged
1,634.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
78.65
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 | Dependent · relationship 01 |
| Policy | B03M000239 |
| Date of birth | 21 Mar 1966 |
| Plan | PLATINUM PPO |
| Covered from | 12 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 78.65 |
| Total | 78.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000974 | 20 Jul 2026 | 121.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000972 | 5 Jun 2025 | 716.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000973 | 1 May 2025 | 797.00 | MERIDIAN HEALTH PLAN | Not denied | — |