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NPHIES polled 3 min ago Search

Claim: CL-20421

Rakan Al Otaibi, Institutional, SAR 12,480.00. Everything NPHIES and the payer said about this claim.

QueuedRakan Al Otaibi, Institutional. Bupa Arabia.

Patient

Name
Rakan Al Otaibi
ID Number
1061713899

Claim details

Claim ID
CL-20421
Claim type
Institutional
Payer
Bupa Arabia
Sent
05 Oct 2026, 09:12
Payer answered
Not yet
Outcome
Pending
Disposition
Queued for adjudication.

Financial totals

Submitted
SAR 12,480.00
Approved
SAR 0.00
Benefit
SAR 0.00
Patient Share
SAR 1,248.00
Payer Share
SAR 11,232.00
Tax
SAR 0.00

Process notes

No notes yet.

NPHIES ID chain

Internal request IDCL-20421
NPHIES request IDRQ-9981-0421-5473
NPHIES responsePending: queued at NPHIES
NPHIES response IDPending: queued at NPHIES
Use the NPHIES response ID when you link or resubmit.

History

Claim sent 05 Oct 2026, 09:12

Sent to NPHIES by Reem Al-Otaibi.

Waiting for the payer Now

No response yet.

Line items (3)

Service Submitted Approved Patient Share Denial Reason Outcome
97005-00Cardiology consultation, specialist 4,597.89 - 459.79 - Queued
11700-00Electrocardiogram, 12 lead 1,576.42 - 157.64 - Queued
55113-00Echocardiography, transthoracic 6,305.69 - 630.57 - Queued

Errors

No errors on this claim.

Raw payload

The exact bundle NPHIES returned. Read only.Copy JSON

Poll summary

Poll NPHIES
Task Status
Waiting
Task ID
7a1f0421-2c05
Extracted Responses
0
Meta Tag
N/A

Payer communication requests

No questions from Bupa Arabia on this claim.

Related

No linked requests on this claim.

Poll history

Date / Time Type Result
05 Oct 2026, 09:12 Status Check Pending
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Assigned. The owner sees it in their queue.
Note added to the case.