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NPHIES polled 3 min ago Search

Claim: CL-20419

Sara Al Qahtani, Professional, SAR 420.00. Everything NPHIES and the payer said about this claim.

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QueuedSara Al Qahtani, Professional. Tawuniya.

Patient

Name
Sara Al Qahtani
ID Number
1061698061

Claim details

Claim ID
CL-20419
Claim type
Professional
Payer
Tawuniya
Sent
Not sent yet
Payer answered
Not sent yet
Outcome
Not sent yet
Disposition
Not sent to NPHIES yet.

Financial totals

Submitted
SAR 420.00
Approved
SAR 0.00
Benefit
SAR 0.00
Patient Share
SAR 41.99
Payer Share
SAR 378.01
Tax
SAR 0.00

Process notes

No notes yet.

NPHIES ID chain

Internal request IDCL-20419
NPHIES request IDCreated when the claim is sent
NPHIES responseNone yet
NPHIES response IDNone yet
Use the NPHIES response ID when you link or resubmit.

History

Claim saved 05 Oct 2026, 09:46

Saved by Reem Al-Otaibi while NPHIES was not answering.

Waiting for NPHIES Now

Sent automatically when NPHIES is back.

Line items (3)

Service Submitted Approved Patient Share Denial Reason Outcome
97005-00Cardiology consultation, specialist 154.74 - 15.47 - Queued
11700-00Electrocardiogram, 12 lead 53.05 - 5.30 - Queued
55113-00Echocardiography, transthoracic 212.21 - 21.22 - 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
7a1f0419-2c05
Extracted Responses
0
Meta Tag
N/A

Payer communication requests

No questions from Tawuniya on this claim.

Related

No linked requests on this claim.

Poll history

No polls yet. The claim has not been sent.

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