NADIA FOSTER
Dependent on policy B05M000430
Claims
1
Attributed to this person
Charged
522.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
78.30
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 | NADIA FOSTER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000430 |
| Date of birth | 28 Aug 1979 |
| Plan | PLATINUM PPO |
| Covered from | 4 Sep 2024 |
| Covered to | 24 Apr 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 78.30 |
| Total | 78.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001812 | 20 May 2025 | 522.00 | NORTHSTAR MUTUAL | Not denied | — |