SOFIA FOSTER
Dependent on policy B03M000701
Claims
2
Attributed to this person
Charged
1,112.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
222.40
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 | B03M000701 |
| Date of birth | 27 Dec 2020 |
| Plan | SILVER HMO |
| Covered from | 12 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 2 | 222.40 |
| Total | 222.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002915 | 24 Dec 2025 | 461.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002914 | 23 Mar 2025 | 651.00 | MERIDIAN HEALTH PLAN | Not denied | — |