ZARA QUINN
Subscriber on policy B09M000430
Claims
1
Attributed to this person
Charged
778.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
15.00
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 | ZARA QUINN |
| Role on the policy | Subscriber |
| Policy | B09M000430 |
| Date of birth | 24 Jul 1971 |
| Plan | GOLD PPO |
| Covered from | 15 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 15.00 |
| Total | 15.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001800 | 22 May 2026 | 778.00 | NORTHSTAR MUTUAL | Not denied | — |