YUSUF FOSTER
Dependent on policy B07M000459
Claims
3
Attributed to this person
Charged
1,113.00
Total submitted
Denied
301.97
2 denied claims
Patient responsibility
30.00
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 | YUSUF FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000459 |
| Date of birth | 31 Jul 1995 |
| Plan | BRONZE EPO |
| Covered from | 11 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001938 | 6 Nov 2025 | 755.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001939 | 25 Oct 2025 | 89.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 32.97 |
| CLM0001940 | 2 Mar 2025 | 269.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 269.00 |