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NPHIES polled 3 min ago Search

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.

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

Internal request IDCL-20399
NPHIES request IDRQ-9981-0399-5187
NPHIES responsePending: queued at NPHIES
NPHIES response IDPending: queued at NPHIES
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
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Assigned. The owner sees it in their queue.
Note added to the case.