TOMAS IQBAL
Dependent on policy B01M000186
Claims
2
Attributed to this person
Charged
252.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
29.80
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 | TOMAS IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000186 |
| Date of birth | 24 Sep 2010 |
| 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 | 29.80 |
| Total | 29.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000794 | 9 May 2026 | 103.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000795 | 12 Apr 2025 | 149.00 | NORTHSTAR MUTUAL | Not denied | — |