YUSUF QUINN
Dependent on policy B06M000666
Claims
3
Attributed to this person
Charged
867.00
Total submitted
Denied
249.59
2 denied claims
Patient responsibility
17.10
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | YUSUF QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000666 |
| Date of birth | 30 Jul 1963 |
| Plan | SILVER HMO |
| Covered from | 14 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 17.10 |
| Total | 17.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002944 | 25 Jun 2026 | 676.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 172.59 |
| CLM0002943 | 26 Nov 2024 | 77.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 77.00 |
| CLM0002945 | 20 Nov 2024 | 114.00 | NORTHSTAR MUTUAL | Not denied | — |