GRACE QUINN
Dependent on policy B06M000767
Claims
1
Attributed to this person
Charged
257.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
38.55
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 | GRACE QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000767 |
| Date of birth | 28 Sep 1963 |
| Plan | SILVER HMO |
| Covered from | 30 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 38.55 |
| Total | 38.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003390 | 8 Apr 2026 | 257.00 | CASCADE CARE | Not denied | — |