GRACE FOSTER
Subscriber on policy B03M000166
Claims
2
Attributed to this person
Charged
788.00
Total submitted
Denied
446.00
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 | GRACE FOSTER |
| Role on the policy | Subscriber |
| Policy | B03M000166 |
| Date of birth | 30 Apr 1975 |
| Plan | BRONZE EPO |
| Covered from | 23 Jun 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000679 | 24 Aug 2026 | 342.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000678 | 28 Sep 2025 | 446.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 446.00 |