WENDY QUINN
Subscriber on policy B10M000862
Claims
3
Attributed to this person
Charged
1,075.00
Total submitted
Denied
126.86
1 denied claims
Patient responsibility
64.80
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 | WENDY QUINN |
| Role on the policy | Subscriber |
| Policy | B10M000862 |
| Date of birth | 11 Jan 1953 |
| Plan | SILVER HMO |
| Covered from | 13 Aug 2024 |
| Covered to | 21 Mar 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 64.80 |
| Total | 64.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003653 | 14 May 2025 | 324.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003655 | 5 Mar 2025 | 284.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 126.86 |
| CLM0003654 | 24 Sep 2024 | 467.00 | NORTHSTAR MUTUAL | Not denied | — |