TOMAS QUINN
Subscriber on policy B09M000549
Claims
2
Attributed to this person
Charged
248.00
Total submitted
Denied
110.43
2 denied claims
Patient responsibility
0.00
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 | TOMAS QUINN |
| Role on the policy | Subscriber |
| Policy | B09M000549 |
| Date of birth | 20 Jun 1962 |
| Plan | BRONZE EPO |
| Covered from | 15 Nov 2024 |
| Covered to | 1 May 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002315 | 13 May 2025 | 87.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 87.00 |
| CLM0002314 | 2 Feb 2025 | 161.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 23.43 |