IVAN QUINN
Dependent on policy B09M000286
Claims
3
Attributed to this person
Charged
883.00
Total submitted
Denied
116.00
1 denied claims
Patient responsibility
50.60
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 | IVAN QUINN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000286 |
| Date of birth | 25 Dec 1984 |
| Plan | BRONZE EPO |
| Covered from | 17 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 50.60 |
| Total | 50.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001184 | 26 May 2026 | 116.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 116.00 |
| CLM0001183 | 12 Feb 2025 | 514.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001185 | 12 Feb 2025 | 253.00 | NORTHSTAR MUTUAL | Not denied | — |