SOFIA FOSTER
Dependent on policy B02M000076
Claims
3
Attributed to this person
Charged
804.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
17.60
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 01 |
| Policy | B02M000076 |
| Date of birth | 15 Jun 1950 |
| Plan | BRONZE EPO |
| Covered from | 5 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 17.60 |
| Total | 17.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000352 | 21 Aug 2026 | 644.00 | CASCADE CARE | Not denied | — |
| CLM0000353 | 7 Jan 2025 | 72.00 | CASCADE CARE | Not denied | — |
| CLM0000354 | 2 Sep 2024 | 88.00 | CASCADE CARE | Not denied | — |