LEILA FOSTER
Dependent on policy B09M000438
Claims
1
Attributed to this person
Charged
853.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
170.60
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 | LEILA FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000438 |
| Date of birth | 12 Nov 1989 |
| Plan | PLATINUM PPO |
| Covered from | 17 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 170.60 |
| Total | 170.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001836 | 3 Jun 2025 | 853.00 | MERIDIAN HEALTH PLAN | Not denied | — |