SOFIA FOSTER
Dependent on policy B10M000817
Claims
2
Attributed to this person
Charged
1,303.00
Total submitted
Denied
649.00
1 denied claims
Patient responsibility
98.10
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 | B10M000817 |
| Date of birth | 10 Feb 2019 |
| Plan | GOLD PPO |
| Covered from | 1 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 98.10 |
| Total | 98.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003456 | 26 May 2026 | 649.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 649.00 |
| CLM0003455 | 11 Aug 2025 | 654.00 | MERIDIAN HEALTH PLAN | Not denied | — |