SOFIA FOSTER
Dependent on policy B07M000355
Claims
3
Attributed to this person
Charged
1,865.00
Total submitted
Denied
238.00
1 denied claims
Patient responsibility
166.20
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 FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000355 |
| Date of birth | 7 May 2014 |
| Plan | SILVER HMO |
| Covered from | 30 Jan 2025 |
| Covered to | 14 Oct 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 166.20 |
| Total | 166.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001510 | 23 Nov 2025 | 796.00 | CASCADE CARE | Not denied | — |
| CLM0001512 | 4 Nov 2025 | 238.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 238.00 |
| CLM0001511 | 27 Apr 2025 | 831.00 | CASCADE CARE | Not denied | — |