X12 Ingest & Denial Analytics

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Members›policy B05M000162›TOMAS IQBAL

TOMAS IQBAL

Dependent on policy B05M000162

Claims
1
Attributed to this person
Charged
738.00
Total submitted
Denied
738.00
1 denied claims
Patient responsibility
0.00
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

FieldValue
NameTOMAS IQBAL
Role on the policyDependent · relationship 19
PolicyB05M000162
Date of birth28 Sep 2012
PlanBRONZE EPO
Covered from6 May 2025
Covered to30 Aug 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000068313 Sep 2025738.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY738.00