SOFIA EVANS
Dependent on policy B09M000669
Claims
3
Attributed to this person
Charged
2,344.00
Total submitted
Denied
784.00
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 | SOFIA EVANS |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000669 |
| Date of birth | 13 Feb 1989 |
| Plan | BRONZE EPO |
| Covered from | 13 Apr 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 |
|---|---|---|---|---|---|
| CLM0002840 | 9 Feb 2026 | 858.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002842 | 21 Nov 2025 | 702.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002841 | 2 Aug 2024 | 784.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 784.00 |