CARLA FOSTER
Dependent on policy B01M000528
Claims
3
Attributed to this person
Charged
836.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
138.65
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 | CARLA FOSTER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000528 |
| Date of birth | 27 Jan 1949 |
| Plan | BRONZE EPO |
| Covered from | 21 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 91.20 |
| CARC 96 · Other | 1 | 47.45 |
| Total | 138.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002381 | 9 Mar 2026 | 608.00 | CASCADE CARE | Not denied | — |
| CLM0002382 | 9 Nov 2025 | 155.00 | CASCADE CARE | Not denied | — |
| CLM0002380 | 4 Jun 2025 | 73.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |