PRIYA QUINN
Dependent on policy B09M000629
Claims
3
Attributed to this person
Charged
1,857.00
Total submitted
Denied
1,238.00
2 denied claims
Patient responsibility
92.85
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 | PRIYA QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000629 |
| Date of birth | 12 May 1953 |
| Plan | SILVER HMO |
| Covered from | 11 Mar 2025 |
| Covered to | 29 Dec 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 92.85 |
| Total | 92.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002662 | 2 Jan 2026 | 344.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 344.00 |
| CLM0002663 | 30 Sep 2025 | 619.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002661 | 19 Apr 2025 | 894.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 894.00 |