DAVID QUINN
Dependent on policy B04M000851
Claims
3
Attributed to this person
Charged
898.00
Total submitted
Denied
46.96
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 | DAVID QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000851 |
| Date of birth | 12 Sep 1972 |
| Plan | BRONZE EPO |
| Covered from | 23 Jan 2024 |
| Covered to | 1 Jul 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003672 | 29 May 2024 | 416.00 | CASCADE CARE | Not denied | — |
| CLM0003671 | 16 May 2024 | 116.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 46.96 |
| CLM0003670 | 26 Feb 2024 | 366.00 | CASCADE CARE | Not denied | — |