IVAN FOSTER
Dependent on policy B08M000801
Claims
3
Attributed to this person
Charged
1,760.00
Total submitted
Denied
577.00
1 denied claims
Patient responsibility
125.70
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 | IVAN FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000801 |
| Date of birth | 15 May 2014 |
| Plan | BRONZE EPO |
| Covered from | 6 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 125.70 |
| Total | 125.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003582 | 5 Feb 2026 | 838.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003581 | 16 Jan 2026 | 577.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 577.00 |
| CLM0003583 | 1 Jun 2025 | 345.00 | NORTHSTAR MUTUAL | Not denied | — |