HENRY QUINN
Subscriber on policy B01M000241
Claims
3
Attributed to this person
Charged
415.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
30.00
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 | Subscriber |
| Policy | B01M000241 |
| Date of birth | 25 Feb 1963 |
| Plan | GOLD PPO |
| Covered from | 16 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001022 | 4 Aug 2026 | 106.00 | CASCADE CARE | Not denied | — |
| CLM0001021 | 14 Jun 2026 | 180.00 | CASCADE CARE | Not denied | — |
| CLM0001023 | 24 Jan 2026 | 129.00 | CASCADE CARE | Not denied | — |