HENRY FOSTER
Dependent on policy B03M000683
Claims
1
Attributed to this person
Charged
512.00
Total submitted
Denied
255.65
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 | HENRY FOSTER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000683 |
| Date of birth | 13 Feb 1990 |
| Plan | GOLD PPO |
| Covered from | 19 Mar 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 |
|---|---|---|---|---|---|
| CLM0002844 | 23 Apr 2025 | 512.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 255.65 |