TOMAS IQBAL
Subscriber on policy B03M000560
Claims
1
Attributed to this person
Charged
199.00
Total submitted
Denied
199.00
1 denied claims
Patient responsibility
0.00
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 | TOMAS IQBAL |
| Role on the policy | Subscriber |
| Policy | B03M000560 |
| Date of birth | 3 May 2004 |
| Plan | PLATINUM PPO |
| Covered from | 17 May 2024 |
| Covered to | 13 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002283 | 30 Apr 2024 | 199.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 199.00 |