OMAR FOSTER
Subscriber on policy B05M000888
Claims
3
Attributed to this person
Charged
1,026.00
Total submitted
Denied
85.49
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 | OMAR FOSTER |
| Role on the policy | Subscriber |
| Policy | B05M000888 |
| Date of birth | 12 Aug 1963 |
| Plan | GOLD PPO |
| Covered from | 19 Jun 2024 |
| Covered to | 2 Feb 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003777 | 8 Feb 2025 | 671.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003778 | 9 Nov 2024 | 161.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003776 | 24 Sep 2024 | 194.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 85.49 |