CARLA FOSTER
Subscriber on policy B03M000201
Claims
3
Attributed to this person
Charged
1,669.00
Total submitted
Denied
126.00
1 denied claims
Patient responsibility
158.00
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 | CARLA FOSTER |
| Role on the policy | Subscriber |
| Policy | B03M000201 |
| Date of birth | 7 Sep 1987 |
| Plan | BRONZE EPO |
| Covered from | 13 Jun 2025 |
| Covered to | 6 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 158.00 |
| Total | 158.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000835 | 17 Oct 2025 | 126.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 126.00 |
| CLM0000836 | 7 Sep 2025 | 753.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000837 | 12 Jun 2025 | 790.00 | MERIDIAN HEALTH PLAN | Not denied | — |