SOFIA WILSON
Dependent on policy B08M000266
Claims
3
Attributed to this person
Charged
1,451.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
238.55
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 WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000266 |
| Date of birth | 17 Jun 1958 |
| Plan | GOLD PPO |
| Covered from | 6 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 238.55 |
| Total | 238.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001207 | 26 Feb 2026 | 845.00 | CASCADE CARE | Not denied | — |
| CLM0001206 | 6 Nov 2025 | 367.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0001205 | 7 Jul 2025 | 239.00 | CASCADE CARE | Not denied | — |