CARLA QUINN
Subscriber on policy B02M000441
Claims
1
Attributed to this person
Charged
118.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
17.70
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 | CARLA QUINN |
| Role on the policy | Subscriber |
| Policy | B02M000441 |
| Date of birth | 14 Nov 1983 |
| Plan | BRONZE EPO |
| Covered from | 6 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 17.70 |
| Total | 17.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001879 | 7 May 2025 | 118.00 | NORTHSTAR MUTUAL | Not denied | — |