CARLA IQBAL
Dependent on policy B05M000495
Claims
3
Attributed to this person
Charged
1,414.00
Total submitted
Denied
855.00
2 denied claims
Patient responsibility
110.50
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 | Dependent · relationship 19 |
| Policy | B05M000495 |
| Date of birth | 30 Aug 1996 |
| Plan | SILVER HMO |
| Covered from | 25 Aug 2024 |
| Covered to | 13 Mar 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 110.50 |
| Total | 110.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002129 | 17 Mar 2025 | 855.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 855.00 |
| CLM0002128 | 25 Dec 2024 | 389.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002127 | 15 Nov 2024 | 170.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |