OMAR QUINN
Dependent on policy B09M000829
Claims
3
Attributed to this person
Charged
1,036.00
Total submitted
Denied
295.00
1 denied claims
Patient responsibility
25.50
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 | OMAR QUINN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000829 |
| Date of birth | 14 May 2006 |
| Plan | SILVER HMO |
| Covered from | 11 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 25.50 |
| Total | 25.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003523 | 20 Nov 2025 | 170.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003521 | 29 May 2025 | 571.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003522 | 20 Apr 2025 | 295.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 295.00 |