SOFIA FOSTER
Dependent on policy B09M000404
Claims
2
Attributed to this person
Charged
1,056.00
Total submitted
Denied
710.94
2 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 | SOFIA FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000404 |
| Date of birth | 1 Apr 2000 |
| Plan | BRONZE EPO |
| Covered from | 8 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001684 | 25 Jul 2025 | 506.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 160.94 |
| CLM0001683 | 15 Feb 2025 | 550.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 550.00 |