UMA IQBAL
Dependent on policy B03M000139
Claims
3
Attributed to this person
Charged
1,626.00
Total submitted
Denied
421.00
2 denied claims
Patient responsibility
263.90
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 | UMA IQBAL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000139 |
| Date of birth | 20 Nov 1995 |
| Plan | BRONZE EPO |
| Covered from | 22 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 263.90 |
| Total | 263.90 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000566 | 4 Nov 2025 | 351.00 | CASCADE CARE | Not denied | — |
| CLM0000565 | 13 Sep 2025 | 406.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000567 | 18 Apr 2025 | 869.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 421.00 |