SOFIA FOSTER
Subscriber on policy B02M000004
Claims
2
Attributed to this person
Charged
1,477.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
122.70
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 | Subscriber |
| Policy | B02M000004 |
| Date of birth | 19 Apr 1985 |
| Plan | SILVER HMO |
| Covered from | 10 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 122.70 |
| Total | 122.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000027 | 2 Mar 2026 | 659.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000026 | 16 Mar 2025 | 818.00 | NORTHSTAR MUTUAL | Not denied | — |