LEILA IQBAL
Dependent on policy B05M000199
Claims
3
Attributed to this person
Charged
2,317.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
55.00
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
| Field | Value |
|---|---|
| Name | LEILA IQBAL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000199 |
| Date of birth | 27 Nov 2000 |
| Plan | GOLD PPO |
| Covered from | 6 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 2 | 55.00 |
| Total | 55.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000839 | 29 Dec 2025 | 696.00 | CASCADE CARE | Not denied | — |
| CLM0000841 | 6 Dec 2024 | 728.00 | CASCADE CARE | Not denied | — |
| CLM0000840 | 12 Sep 2024 | 893.00 | CASCADE CARE | Not denied | — |