SOFIA ANDERSON
Dependent on policy B02M000711
Claims
3
Attributed to this person
Charged
1,355.00
Total submitted
Denied
261.00
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 ANDERSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000711 |
| Date of birth | 23 Sep 1996 |
| Plan | PLATINUM PPO |
| Covered from | 25 Apr 2024 |
| Covered to | 12 Feb 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 |
|---|---|---|---|---|---|
| CLM0002992 | 23 Mar 2025 | 261.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 261.00 |
| CLM0002993 | 20 Oct 2024 | 869.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002994 | 26 Jun 2024 | 225.00 | NORTHSTAR MUTUAL | Not denied | — |