WENDY FOSTER
Subscriber on policy B05M000430
Claims
3
Attributed to this person
Charged
861.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
424.50
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 | WENDY FOSTER |
| Role on the policy | Subscriber |
| Policy | B05M000430 |
| Date of birth | 29 Mar 1978 |
| Plan | PLATINUM PPO |
| Covered from | 4 Sep 2024 |
| Covered to | 24 Apr 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 406.90 |
| CARC 2 · Coinsurance | 1 | 17.60 |
| Total | 424.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001809 | 17 Jun 2025 | 147.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001810 | 16 Jun 2025 | 88.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001811 | 21 Oct 2024 | 626.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |