HENRY FOSTER
Dependent on policy B07M000004
Claims
3
Attributed to this person
Charged
1,245.00
Total submitted
Denied
98.00
1 denied claims
Patient responsibility
15.00
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 | HENRY FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000004 |
| Date of birth | 4 Jan 2007 |
| Plan | BRONZE EPO |
| Covered from | 22 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 15.00 |
| Total | 15.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000028 | 12 Jul 2026 | 321.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000027 | 26 Aug 2025 | 826.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000026 | 11 Mar 2025 | 98.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 98.00 |