JULIA QUINN
Subscriber on policy B01M000103
Claims
2
Attributed to this person
Charged
1,466.00
Total submitted
Denied
781.00
2 denied claims
Patient responsibility
445.25
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 | JULIA QUINN |
| Role on the policy | Subscriber |
| Policy | B01M000103 |
| Date of birth | 24 Apr 1955 |
| Plan | BRONZE EPO |
| Covered from | 9 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 445.25 |
| Total | 445.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000414 | 13 Nov 2025 | 781.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 781.00 |
| CLM0000415 | 31 Mar 2024 | 685.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |