AMARA FOSTER
Dependent on policy B01M000650
Claims
3
Attributed to this person
Charged
1,037.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
163.80
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 | AMARA FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000650 |
| Date of birth | 10 Jun 1994 |
| Plan | BRONZE EPO |
| Covered from | 22 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 163.80 |
| Total | 163.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002904 | 12 May 2026 | 252.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 0.00 |
| CLM0002906 | 1 Jan 2026 | 234.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002905 | 4 Oct 2025 | 551.00 | NORTHSTAR MUTUAL | Not denied | — |