ELENA IQBAL
Dependent on policy B04M000379
Claims
2
Attributed to this person
Charged
1,018.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
31.20
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 | ELENA IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000379 |
| Date of birth | 14 Aug 1989 |
| Plan | SILVER HMO |
| Covered from | 20 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 31.20 |
| Total | 31.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001618 | 28 Sep 2025 | 810.00 | CASCADE CARE | Not denied | — |
| CLM0001619 | 3 Apr 2025 | 208.00 | CASCADE CARE | Not denied | — |