ZARA YAMADA
Dependent on policy B08M000047
Claims
3
Attributed to this person
Charged
1,821.00
Total submitted
Denied
891.00
1 denied claims
Patient responsibility
45.20
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 | ZARA YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000047 |
| Date of birth | 4 Jun 2011 |
| Plan | BRONZE EPO |
| Covered from | 16 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 45.20 |
| Total | 45.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000197 | 28 Mar 2026 | 891.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 891.00 |
| CLM0000196 | 10 Mar 2026 | 704.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000198 | 31 Oct 2025 | 226.00 | NORTHSTAR MUTUAL | Not denied | — |