HENRY QUINN
Dependent on policy B07M000835
Claims
2
Attributed to this person
Charged
520.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.20
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 | HENRY QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000835 |
| Date of birth | 2 May 1976 |
| Plan | GOLD PPO |
| Covered from | 9 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 40.20 |
| Total | 40.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003440 | 10 Aug 2026 | 252.00 | CASCADE CARE | Not denied | — |
| CLM0003439 | 12 Oct 2025 | 268.00 | CASCADE CARE | Not denied | — |