DAVID QUINN
Dependent on policy B09M000401
Claims
3
Attributed to this person
Charged
1,803.00
Total submitted
Denied
993.00
2 denied claims
Patient responsibility
121.50
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 | Dependent · relationship 01 |
| Policy | B09M000401 |
| Date of birth | 2 Jan 1997 |
| Plan | PLATINUM PPO |
| Covered from | 21 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 121.50 |
| Total | 121.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001656 | 8 May 2025 | 502.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 502.00 |
| CLM0001657 | 27 Apr 2025 | 491.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 491.00 |
| CLM0001658 | 21 Sep 2024 | 810.00 | MERIDIAN HEALTH PLAN | Not denied | — |