SOFIA QUINN
Dependent on policy B03M000443
Claims
3
Attributed to this person
Charged
1,059.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
48.10
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 | SOFIA QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000443 |
| Date of birth | 2 Oct 2002 |
| Plan | GOLD PPO |
| Covered from | 25 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 48.10 |
| Total | 48.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001827 | 25 Jul 2026 | 856.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001828 | 8 Feb 2026 | 129.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001829 | 20 Sep 2024 | 74.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |