SOFIA PATEL
Subscriber on policy B04M000165
Claims
1
Attributed to this person
Charged
441.00
Total submitted
Denied
441.00
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 PATEL |
| Role on the policy | Subscriber |
| Policy | B04M000165 |
| Date of birth | 30 Apr 2002 |
| Plan | GOLD PPO |
| Covered from | 20 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000751 | 27 Feb 2025 | 441.00 | CASCADE CARE | CARC 18 · DUPLICATE | 441.00 |