ZARA FOSTER
Dependent on policy B04M000118
Claims
3
Attributed to this person
Charged
1,581.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
526.85
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 | ZARA FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000118 |
| Date of birth | 30 Dec 2009 |
| Plan | SILVER HMO |
| Covered from | 25 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 486.85 |
| CARC 3 · Copay | 1 | 40.00 |
| Total | 526.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000554 | 25 Dec 2025 | 461.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000552 | 11 Sep 2025 | 749.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000553 | 25 Jul 2025 | 371.00 | MERIDIAN HEALTH PLAN | Not denied | — |