PRIYA IQBAL
Dependent on policy B05M000151
Claims
3
Attributed to this person
Charged
1,816.00
Total submitted
Denied
982.74
3 denied claims
Patient responsibility
212.55
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 | PRIYA IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000151 |
| Date of birth | 1 Mar 1996 |
| Plan | PLATINUM PPO |
| Covered from | 19 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 212.55 |
| Total | 212.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000624 | 21 May 2025 | 719.00 | CASCADE CARE | CARC 11 · CODING | 212.74 |
| CLM0000623 | 21 Mar 2025 | 770.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 770.00 |
| CLM0000622 | 19 Jan 2025 | 327.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |