CARLA IQBAL
Subscriber on policy B01M000186
Claims
2
Attributed to this person
Charged
1,120.00
Total submitted
Denied
872.00
1 denied claims
Patient responsibility
49.60
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 | CARLA IQBAL |
| Role on the policy | Subscriber |
| Policy | B01M000186 |
| Date of birth | 15 Nov 1967 |
| Plan | GOLD PPO |
| Covered from | 24 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 49.60 |
| Total | 49.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000792 | 17 Sep 2025 | 248.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000791 | 10 Sep 2025 | 872.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 872.00 |