SOFIA ANDERSON
Subscriber on policy B09M000587
Claims
2
Attributed to this person
Charged
499.00
Total submitted
Denied
375.32
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B09M000587 |
| Date of birth | 7 Mar 1973 |
| Plan | BRONZE EPO |
| Covered from | 27 Dec 2024 |
| Covered to | 15 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002491 | 31 Mar 2025 | 218.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 94.32 |
| CLM0002490 | 31 Dec 2024 | 281.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 281.00 |