Claim: CL-20399
Maha Al Dossari, Institutional, SAR 1,850.00. Everything NPHIES and the payer said about this claim.
QueuedMaha Al Dossari, Institutional. MedGulf.
Waiting for the payer. NPHIES has the claim but the payer has not answered. This page updates when the response arrives. You can check the status now, or cancel the request before the payer answers.
Patient
- Name
- Maha Al Dossari
- ID Number
- 1061539681
Claim details
- Claim ID
- CL-20399
- Claim type
- Institutional
- Payer
- MedGulf
- Sent
- 02 Oct 2026, 14:30
- Payer answered
- Not yet
- Outcome
- Pending
- Disposition
- Queued for adjudication.
Financial totals
- Submitted
- SAR 1,850.00
- Approved
- SAR 0.00
- Benefit
- SAR 0.00
- Patient Share
- SAR 185.00
- Payer Share
- SAR 1,665.00
- Tax
- SAR 0.00
Process notes
No notes yet.
NPHIES ID chain
Use the NPHIES response ID when you link or resubmit.
History
Claim sent 02 Oct 2026, 14:30
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 | 681.58 | - | 68.16 | - | Queued |
| 11700-00Electrocardiogram, 12 lead | 233.68 | - | 23.37 | - | Queued |
| 55113-00Echocardiography, transthoracic | 934.74 | - | 93.47 | - | Queued |
Errors
No errors on this claim.
Raw payload
The exact bundle NPHIES returned. Read only.Copy JSON
Poll summary
- Task Status
- Waiting
- Task ID
- 7a1f0399-2c05
- Extracted Responses
- 0
- Meta Tag
- N/A
Payer communication requests
No questions from MedGulf on this claim.
Related
No linked requests on this claim.
Poll history
| Date / Time | Type | Result |
|---|---|---|
| 02 Oct 2026, 14:30 | Status Check | Pending |