DAVID YAMADA
Subscriber on policy B07M000604
Claims
3
Attributed to this person
Charged
1,352.00
Total submitted
Denied
815.00
2 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 | DAVID YAMADA |
| Role on the policy | Subscriber |
| Policy | B07M000604 |
| Date of birth | 9 May 1978 |
| Plan | BRONZE EPO |
| Covered from | 20 Oct 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 |
|---|---|---|---|---|---|
| CLM0002551 | 26 Dec 2024 | 557.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 557.00 |
| CLM0002550 | 20 Dec 2024 | 258.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 258.00 |
| CLM0002549 | 23 Oct 2024 | 537.00 | NORTHSTAR MUTUAL | Not denied | — |