YUSUF QUINN
Dependent on policy B10M000899
Claims
2
Attributed to this person
Charged
766.00
Total submitted
Denied
412.00
2 denied claims
Patient responsibility
230.10
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 | YUSUF QUINN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000899 |
| Date of birth | 9 Jun 2014 |
| Plan | BRONZE EPO |
| Covered from | 22 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 230.10 |
| Total | 230.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003828 | 4 Oct 2025 | 354.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0003829 | 2 Sep 2024 | 412.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 412.00 |