PRIYA QUINN
Dependent on policy B03M000313
Claims
3
Attributed to this person
Charged
1,485.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
10.95
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 | PRIYA QUINN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000313 |
| Date of birth | 24 Dec 1980 |
| Plan | GOLD PPO |
| Covered from | 24 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 10.95 |
| Total | 10.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001255 | 19 May 2026 | 819.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001254 | 21 Jul 2024 | 73.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001253 | 28 Apr 2024 | 593.00 | NORTHSTAR MUTUAL | Not denied | — |