VICTOR IQBAL
Subscriber on policy B04M000849
Claims
3
Attributed to this person
Charged
1,627.00
Total submitted
Denied
668.00
1 denied claims
Patient responsibility
175.00
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 | VICTOR IQBAL |
| Role on the policy | Subscriber |
| Policy | B04M000849 |
| Date of birth | 21 Dec 1971 |
| Plan | PLATINUM PPO |
| Covered from | 16 Jan 2025 |
| Covered to | 7 Aug 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 175.00 |
| Total | 175.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003664 | 19 Aug 2025 | 875.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003665 | 3 May 2025 | 668.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 668.00 |
| CLM0003663 | 8 Apr 2025 | 84.00 | NORTHSTAR MUTUAL | Not denied | — |