SOFIA QUINN
Dependent on policy B04M000625
Claims
3
Attributed to this person
Charged
956.00
Total submitted
Denied
733.00
1 denied claims
Patient responsibility
23.55
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 | B04M000625 |
| Date of birth | 11 Sep 1999 |
| Plan | PLATINUM PPO |
| Covered from | 23 Jan 2025 |
| Covered to | 1 May 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 23.55 |
| Total | 23.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002715 | 25 May 2025 | 733.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 733.00 |
| CLM0002716 | 12 Apr 2025 | 157.00 | CASCADE CARE | Not denied | — |
| CLM0002717 | 10 Mar 2025 | 66.00 | CASCADE CARE | Not denied | — |