LEILA QUINN
Dependent on policy B09M000567
Claims
3
Attributed to this person
Charged
1,688.00
Total submitted
Denied
289.83
1 denied claims
Patient responsibility
21.40
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 | LEILA QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000567 |
| Date of birth | 11 May 1960 |
| Plan | SILVER HMO |
| Covered from | 16 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 21.40 |
| Total | 21.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002398 | 30 Sep 2025 | 795.00 | CASCADE CARE | Not denied | — |
| CLM0002397 | 20 Jul 2025 | 786.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 289.83 |
| CLM0002399 | 14 Apr 2025 | 107.00 | CASCADE CARE | Not denied | — |