OMAR IQBAL
Dependent on policy B05M000162
Claims
1
Attributed to this person
Charged
131.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
26.20
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 | OMAR IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000162 |
| Date of birth | 9 Sep 2009 |
| Plan | BRONZE EPO |
| Covered from | 6 May 2025 |
| Covered to | 30 Aug 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 26.20 |
| Total | 26.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000684 | 18 Jul 2025 | 131.00 | MERIDIAN HEALTH PLAN | Not denied | — |