HENRY QUINN
Dependent on policy B08M000124
Claims
3
Attributed to this person
Charged
873.00
Total submitted
Denied
501.07
3 denied claims
Patient responsibility
0.00
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 19 |
| Policy | B08M000124 |
| Date of birth | 12 Jun 2014 |
| Plan | SILVER HMO |
| Covered from | 3 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000563 | 11 Dec 2025 | 157.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 58.95 |
| CLM0000562 | 21 Sep 2025 | 292.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 292.00 |
| CLM0000561 | 4 Sep 2025 | 424.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 150.12 |