DAVID QUINN
Subscriber on policy B08M000267
Claims
2
Attributed to this person
Charged
528.00
Total submitted
Denied
217.00
1 denied claims
Patient responsibility
62.20
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 | DAVID QUINN |
| Role on the policy | Subscriber |
| Policy | B08M000267 |
| Date of birth | 22 Oct 1951 |
| Plan | GOLD PPO |
| Covered from | 26 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 62.20 |
| Total | 62.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001213 | 31 Jul 2025 | 217.00 | CASCADE CARE | CARC 109 · COB | 217.00 |
| CLM0001212 | 22 Mar 2025 | 311.00 | CASCADE CARE | Not denied | — |