X12 Ingest & Denial Analytics

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Members›policy B01M000065›LEILA IQBAL

LEILA IQBAL

Dependent on policy B01M000065

Claims
1
Attributed to this person
Charged
69.00
Total submitted
Denied
69.00
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

FieldValue
NameLEILA IQBAL
Role on the policyDependent · relationship 19
PolicyB01M000065
Date of birth25 Nov 1983
PlanGOLD PPO
Covered from1 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000027820 Apr 202569.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION69.00