HENRY QUINN
Dependent on policy B08M000783
Claims
3
Attributed to this person
Charged
2,246.00
Total submitted
Denied
587.83
2 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 | B08M000783 |
| Date of birth | 29 Mar 2014 |
| Plan | PLATINUM PPO |
| Covered from | 15 Sep 2024 |
| Covered to | 16 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003505 | 4 Apr 2025 | 601.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003503 | 21 Mar 2025 | 880.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 296.47 |
| CLM0003504 | 29 Sep 2024 | 765.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 291.36 |