LEILA FOSTER
Dependent on policy B09M000625
Claims
1
Attributed to this person
Charged
525.00
Total submitted
Denied
230.89
1 denied claims
Patient responsibility
0.00
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 | LEILA FOSTER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000625 |
| Date of birth | 14 Feb 1976 |
| Plan | GOLD PPO |
| Covered from | 26 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002641 | 5 Feb 2025 | 525.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 230.89 |