TOMAS QUINN
Dependent on policy B02M000118
Claims
1
Attributed to this person
Charged
598.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
119.60
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 | Dependent · relationship 19 |
| Policy | B02M000118 |
| Date of birth | 13 Jun 1980 |
| Plan | SILVER HMO |
| Covered from | 12 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 119.60 |
| Total | 119.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000539 | 11 Mar 2026 | 598.00 | NORTHSTAR MUTUAL | Not denied | — |