ZARA FOSTER
Subscriber on policy B04M000494
Claims
3
Attributed to this person
Charged
1,694.00
Total submitted
Denied
237.96
1 denied claims
Patient responsibility
72.30
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 | Subscriber |
| Policy | B04M000494 |
| Date of birth | 15 Sep 1964 |
| Plan | GOLD PPO |
| Covered from | 31 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 72.30 |
| Total | 72.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002130 | 18 Jan 2026 | 482.00 | CASCADE CARE | Not denied | — |
| CLM0002129 | 29 Oct 2025 | 653.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 237.96 |
| CLM0002128 | 15 Sep 2025 | 559.00 | CASCADE CARE | Not denied | — |