SOFIA YAMADA
Dependent on policy B06M000228
Claims
1
Attributed to this person
Charged
141.00
Total submitted
Denied
141.00
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 | SOFIA YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000228 |
| Date of birth | 17 Mar 1971 |
| Plan | SILVER HMO |
| Covered from | 9 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001091 | 8 Jan 2025 | 141.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 141.00 |