HENRY QUINN
Subscriber on policy B03M000049
Claims
1
Attributed to this person
Charged
667.00
Total submitted
Denied
667.00
1 denied claims
Patient responsibility
0.00
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 | HENRY QUINN |
| Role on the policy | Subscriber |
| Policy | B03M000049 |
| Date of birth | 7 Oct 1979 |
| Plan | BRONZE EPO |
| Covered from | 24 Jun 2024 |
| Covered to | 21 Jan 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000212 | 31 May 2024 | 667.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 667.00 |