Claim: CL-20402
Abdullah Al Ghamdi, Professional, SAR 1,120.50. Everything NPHIES and the payer said about this claim.
PartialAbdullah Al Ghamdi, Professional. Bupa Arabia.
Partly approved. Bupa Arabia approved SAR 705.92 of SAR 1,008.46. The rest was not approved. The patient pays SAR 112.04.
- Name
- Abdullah Al Ghamdi
- ID Number
- 1061563438
- Claim ID
- CL-20402
- Claim type
- Professional
- Payer
- Bupa Arabia
- Sent
- 30 Sep 2026, 11:30
- Payer answered
- 30 Sep 2026, 11:34
- Outcome
- Partial
- Disposition
- Part of the claim was approved as per contract.
- Submitted
- SAR 1,120.50
- Approved
- SAR 705.92
- Benefit
- SAR 705.92
- Patient Share
- SAR 112.04
- Payer Share
- SAR 1,008.46
- Tax
- SAR 0.00
Adjudicated with changes. Part of the net amount was not approved.
Internal request IDCL-20402
NPHIES request IDRQ-9981-0402-5226
NPHIES responseComplete, outcome Partial
NPHIES response IDRS-6120-0402-2814
Claim sent 30 Sep 2026, 11:30
Sent to NPHIES by Reem Al-Otaibi.
Payer responded 30 Sep 2026, 11:34
Bupa Arabia partly approved the claim.
| Service |
Submitted |
Approved |
Patient Share |
Denial Reason |
Outcome |
| 97005-00Cardiology consultation, specialist |
412.82 |
260.08 |
41.28 |
- |
Partial |
| 11700-00Electrocardiogram, 12 lead |
141.54 |
89.17 |
14.15 |
- |
Partial |
| 55113-00Echocardiography, transthoracic |
566.14 |
356.67 |
56.61 |
- |
Partial |
The exact bundle NPHIES returned. Read only.Copy JSON
- Task Status
- Completed
- Task ID
- 7a1f0402-2c05
- Extracted Responses
- 1
- Meta Tag
- N/A
Payer communication requests
No questions from Bupa Arabia on this claim.
No linked requests on this claim.
| Date / Time |
Type |
Result |
| 30 Sep 2026, 11:34 |
Poll |
Complete |