ZARA IQBAL
Dependent on policy B04M000872
Claims
2
Attributed to this person
Charged
995.00
Total submitted
Denied
467.00
2 denied claims
Patient responsibility
343.20
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 | ZARA IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000872 |
| Date of birth | 1 Sep 1988 |
| Plan | PLATINUM PPO |
| Covered from | 10 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 343.20 |
| Total | 343.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003778 | 4 Mar 2026 | 467.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 467.00 |
| CLM0003779 | 28 Aug 2025 | 528.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |