YUSUF IQBAL
Dependent on policy B03M000519
Claims
1
Attributed to this person
Charged
166.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
24.90
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 | YUSUF IQBAL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000519 |
| Date of birth | 17 Aug 2006 |
| Plan | SILVER HMO |
| Covered from | 5 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 24.90 |
| Total | 24.90 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002131 | 17 Feb 2025 | 166.00 | NORTHSTAR MUTUAL | Not denied | — |